Panelists, From Left: David Kibbe, John Sharp, John Marzano
I attended the “Meet the Bloggers-Provider Edition” session yesterday at HIMSS 2011 where the goal was to understand the experiences of providers with social media. Rich Elmore (@richelmore and @allscripts), VP of Strategic Initiatives at Allscripts moderated the panel. His blog is Healthcare Technology News.
The panelists included David Kibbe, Senior Advisor at the American Academy of Family Physicians
(The Health Care Blog, Kaiser Health News), John Sharp, Manager, Research Informatics, Cleveland Clinic (@johnsharp, @clevelandclinic, Facebook), and John Marzano, VP and Chief Communications Officer of Orlando Health (Facebook, YouTube).
Here are my notes from the session. While these are not direct verbatim quotes from these experts, I think you will find their insights valuable:
Rich Elmore: How did you get started in social media?
David Kibbe: We started by meeting a desire providers had to find another family physician like him or her who had had success using EHR
Primarily used a list-serv via email, and meetings, phone, traditional communications, but the listserv went from 38 doctors to 1200 physicians in 1 year, creating thousands of conversations around EMR each month
John Sharp: Waded into social media over time. Initially independent efforts initially – a physician here, a nurse there, and a few people in IT, doing sort of unofficial things. Our Chief Marketing Officer really saw that this was going to take off. In Feb 2009, he developed a strategy with both public and corporate communication and marketing people and then bbrought in people like myself who were already actie in social media to develop a social media committee – work group – and a social media policy.
Approached doing a top down approach, because until that time had been a bottom up. CMO presented a strategy to the board of directors. Because we’re a healthcare organization trying to have a national presence, he made the case that this would help our national efforts as well. It is worth doing, he proved we could put the safety controls in place. Facebook presence, Twitter for physician chats, and a big emphasis on wellness, which is core to our organization.
John Marzano: Local economy was one of the main triggers for us. Florida was hit harder than a lot of areas of the country. Our local news media was disappearing. Reporters were getting laid off. There wasn’t a good resource there to pitch stories to. What are some other tactical options we can use to get our story out and tell our story.
We began to look at Facebook & YouTube because of the use of video. Our news team then became news producers instead of news producers. They began spinning our story the way we wanted to without having to pitch something in a controversial angle just to get the news coverage. I was blessed to have one of two twenty-somethings on our team.
We don’t look at this as the be-all and the end-all. It’s just another tacitc that we utilize as part of telling our story. We’re blessed at Orlando Health for having some great brands within a brand. To be able to effectively tell our story has been very advantageous for us. We’re just short of 9,000 fans on Facebook. Close to 59,000 hits on our YouTube site.
Rich Elmore: From a provider perspective, are you seeing much patient response?
John Marzano: The biggest hits we get on our YouTube site are prospective patients trying to get an idea of what the facilities are like. You can really show the facilities and really tell our story in less than 4 minutes. These are beautiful videos – this is our most popular type of video. It’s another way to communicate and interact with patients – people who want to learn about your services.
David Kibbe: About 25% of our members now use web portals in their services. With stage 1 and particularly stage 2 meaningful use in the next 5 years, this will grow significantly. What are the safety controls you’ve put in place?
John Sharp: Good social media policy should be in place. Also, limited or controled number of people who have access to the corporate accounts who know the party line and help stick to the party line. Complaints about their billing office, but they say you just have to respond.
Rich: What role will participatory health play in social media?
David Kibbe: That’s a huge question. As one of the co-founders of the participatory medicine movement. Participatory medicine is more than any particular kind of social media. It’s about real exchange between providers and patients and betweem patients and family members in a way that is real and meaninful. It is something that can be enabled by health information technology, but HIT and social media technology in and of itself is not sufficient to make it happen.
John Sharp: EMR and EHR have not yet converged with social media. I think this will happen i nthe net couple of years, nad I can envision a time when through your EHR you can actually be connected with others of the same disease or condition by decision – you have to choose to connect – a Twitter feed or similar. This is particulalr y in high demand in diabetes.
In rare diseases, we often see a lot of people interacting via Google groups and blogs. Our patient education people were very active in socail media. They connected with these communitieis and actually organized a meet-up at our hostpicatl. Patient meetups around a specific condition is a real opportunity in the future.
John Marzano: People fear coming to the hospital. It’s not always a desirable place to go. If we engage them in their home, it’s going to create a more synergistic relationship before the experience or utilization occurs.
Rich: What are some of the legal and ethical considerations?
John Marzano: We had a former disgruntled employee who took his argument to our Facebook site right fromt he get-go. Early on, we had a challenge that helped get our feet wet in this whole process. Every day I wonder if the executives were going to come in and say “What have you done to us?” WE allowed him the opportunity to express his concern, and we enlisted some help in how to respond to him. The community ended up protecting the organization, and the one individual then began attacking the community, and we drew the line. WE have an etiquette policy set up, and we also have an overall policy for use of social media within our organization.
Initially we allow it. When it gets abusive, we eliminate it.
We respond within 24 to 48 hours and we respond in a very matter of fact way. WE often give people a connect point offline that will help resolve an issue directly with someone. There are people who are wondering whether to get involved in social media. The bottom line is: the world’s not going to end if you do.
David Kibbe: From the perspective of a personal blogger, anybody who puts his or her opinion out on a website that’s established is looking for trouble. There are people out there who will not like what you say and some who will want to attack you viciously. You’re making yourself vulnerable. I have stopped blogging for websites taht don’t moderate their comments. The reason is that when the crazies take over, the really meaningful comments – the dialogue and the conversation I’m trying to get going – when the crazies take over, this dialogue stops.
I want to blog where there’s some screen – not to censor it – but I just don’t want people to say things that are inane, insensitive and often not about the topic.
What are the opportuniteis and threats to the provider?
Rich: What other types of innovations have you seen in social media in your space?
John Sharp: Campaign called “Let’s Move It” – combination of video, mobile app and opportunity to submit videos, tie in with local sports teams to get people up and moving. People submit videos of themselves moving around. Fun stuff like a guy doing push ups with his toddler sitting on his back. We then tie in local sports celebrities. A tie in with local sports and wellness, exercise, etc. – successful in northeast Ohio.
John Marzano: For Arnold Palmer hospital campaign, we put out a call “Meet Our Kids” – a call through our sites. Send us a photo/video of your child – any age – and we’re pulling those in to our TV spots, print ads and micro sites. It’s saved us a lot of money and production. We’ve had over 300 photos uploaded for this campaign.
Winnie Palmer is known throughout its region as a baby hospital – 2nd highest # of births in the country. We launched a micro site called “AccordingtoWInnie.com” and put videos about surgery, etc.. got 5,000+ unique visitors in one month. This allows us to know what our patients are telling us we should be focusing on: hysterectomy, minimally invasive GYN surgery, etc.
Rich: Is it hard to get physicians to engage in social media?
David Kibbe: Kaiser Health in Hawaii had decreased face-to-face visits by 26% in one year by permitting email consultations with their patients.
The docs loved it because it wasn’t taking up their time with a lot of small problems. You’re taking away their livelihood in a fee-for-service environment. Physicians in primary care who are reimbursed by fee-for-service are paid by the visit. They’re already stressed economically, so it’s very hard to have them do the right thing when its economically hurting them.
When we have payment reform that allows providers to use technology to take better care of patients without costing them their salaries, we will see an explosion in social media, because that allows us to close the collaboration gap.
John Sharp: Twitter takes time, and getting involved in social media is still the exception and not the rule.
John Marzano: The more physician expert videos we produce and put on our site, the more physicians that call on us and ask us to include them. Once they see it, they’re not threatened. They realize it doesn’t have any harm, and there’s peer pressure that they want to be involved in it as well.
Rich: What’s your method for determining topics to blog about?
John Marzano: Our Top 6 are: Pediatrics, OBGYN, Womens Health, Cardiac, Cancer and Orthopedics.
…but we’ll do some fun things around things like Heart Month, and focusing on Pink October, focused on breast cancer for the entire month.
Rich: What are the implications for the EHR – for example, the boundaries for what gets included in the medical record?
John Sharp: Opportunities for future integration. Get an email or something from a patient, that’s unsecure, and they will copy and paste that into a note so that it’s documented. We haven’t gone to one-to-one communication through any sort of social network because there are legal implications around that.
Medical information as opposed to medical advice being given electronically is very different.
These are considered public media.
David Kibbe: Started writing about “clinical groupware” primarily because I didn’t want to talk about EHRs anymore. The meaningful use rules are moving us toward clinical groupware. Stage 1 doesn’t require a lot of reaching out to the patient, but it does require some. In Stage 2, we’re going to see that medical practices will not be able to function without a patient portal, without the means to move patient data outside their data source not just to their patients but also to the providers they refer to.
People have so many ideas about what EHR is.