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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 @Seth Bokser, MD, MPH Associate Clinical Professor, UCSF Medical School Medical Director for IT, UCSF Benioff Children s Hospital d) 2 Social Media Networks e) 3 or more Social Media Networks What is Social Media? Learn how Social Media is being applied in healthcare today -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 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 1

Blogs and Wikis Today, I find that more people know me from my blog writings than from my 200 peer-reviewed articles and six books, and that I receive more direct feedback about my blog posts than about virtually any of my writings in more traditional 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 a) 0-20% b) 21-40% c) 41-60% d) 61-80% e) 81-100% 2

Web 1.0 72% of internet users say they looked online for health information of one kind or another within the past year. 35% of U.S. Adults Online Diagnosers Web 2.0 I sort of look up to them and say If they can do it, maybe I can do it. -Teenager in Ontario Hospital speaking of finding other teenage hockey players with his diagnosis Hmm sometimes we do, like about doctors and stuff like he has a funny hairdo or like medication or stuff like that like we compare you know oh did you take like what happened when you did that. We kind of compare but apart from that we don't say like oh yeah I am going for surgery for nanana, it is not like professional, it is just 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 to 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 Opportunities Connect Challenges Maintain professionalism and trust Connect Maintain professionalism and trust Engage patients where they live Respect patients privacy Leverage the masses to empower, educate, and problem solve Protect patients from inaccurate, anxiety provoking, and dangerous health info online Gartner Research. Forecast: Social Media Revenue, Worldwide, 2011-2016 http://www.gartner.com/newsroom/id/2092217. Accessed March 25, 2013 3

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 US Medical Schools Reporting Unprofessional Content Posted by Students using Social Media 60% 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. 50% 40% 30% 20% 10% 0% 60% (47/78) of U.S. medical schools reported incidents of students posting unprofessional online content 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 JAMA. 2009;302(12):1309-1315. doi:10.1001/jama.2009.1387 4

Engage patients where they live Respect patients privacy 1996 2009 2013 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 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 of the covered entity BAs are regulated directly under HIPAA and the BA Agreement with the covered entity Recently, we suspended a user who registered as a patient in the Mood community. This user was not a patient, but rather a computer program that scrapes (i.e. reads and stores) forum information. Our system, which alerts us when an account has looked at too many posts or too many patient profiles within a specified time interval, detected the user. We have verified the account was linked to a major media monitoring company, and we have since sent a cease and desist letter to its executives. http://blog.patientslikeme.com/2010/05/20/bentransparencymessage/ 5

Separate personal and professional personas Do not use text messaging for medical interaction http://www.aap.org/en-us/my-aap/documents/socialmedia_guidelines.pdf Social media comes down to this Golden Rule: If it applies to traditional media or the Internet, it probably applies to most public social media platforms too 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 Crowd + Outsourcing = Crowdsourcing 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. Brabham, Daren (2008), "Crowdsourcing as a Model for Problem Solving: An Introduction and Cases", Convergence: The International Journal of Research into New Media Technologies 14 (1): 75 90 6

#Pro-ana #Pro-mia #Thinspiration San Francisco, CA I was a few pounds overweight and needed support. I found a great site where everyone gave each other weight-loss tips. I shared a photo of myself and got 47 comments mostly saying how fat I was. It really motivated me. I lost 3 stone with the help of that site. - 14-year-old female with anorexia http://www.huffingtonpost.co.uk/2012/10/12/social-media-anorexia-bulimia-young-people_n_1962730.html 20 th Century 21 st Century 7

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