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Hospitals begin to recognize social media’s potential to improve patient experience


“In Canada in health care we’re at a point where most hospitals accept the role of social media for branding and communication, but only the lead adopters are using it for patient engagement and for clinical use.” – Ann Fuller, public relations director,   Children’s Hospital of Eastern Ontario (CHEO)

Call up the website home page for any large Canadian hospital and you’ll likely spot the familiar icons that link to the institution’s facebook, Twitter and YouTube accounts.

Hospitals are inherently conservative institutions and, as such, have been relative latecomers to adopt social media, which are broadly defined as digital channels that can facilitate timely, collaborative and interactive communication.

As they enter the social media fray, hospitals face a host of challenges and decisions. These range from basic upkeep—nothing is more frustrating to a potential user than a neglected or stale-dated facebook or Twitter account—to deciding how interactive to be with patients, and what staff should be trained and involved in social media use.

From marketing to improved care

Not all hospitals haven entered the fray—for example, smaller hospitals may not be able to afford the expertise and time involved in establishing a social media presence—and among those that have, how they use social media varies significantly.

Many still use the channels for marketing and old-style public relations communication—for example posting news releases—while some larger hospitals are more active, have thousands of followers, and can track and address patient concerns.

But the potential of using social media to improve patient care and patient experience is only beginning to be realized, according to health care digital communication leaders.

That’s not surprising because it’s only been a few years since hospitals began to take social media seriously; the Ontario Hospital Association hosted its fourth Social Media in Health Care conference just last month; the first was Jan 21, 2010.

Social media policies can allay concerns about risk

The issue of privacy and risk dominated discussions about social media several years ago, but that concern has begun to be addressed as hospitals formulate and adopt social media policies (see CHEO policy, for example) that spell out ground rules for use.

An emerging debate contrasts the approach of hospitals that use a single channel “firehose” social media approach—institutions that have just one facebook and one Twitter account for all communication—and those that have multiple social media channels.

To Ed Bennett, who manages web operations at the University of Maryland Medical System, the progression from hosting single to multiple speciality channels—from addressing patient concerns at a broad level, to also addressing narrower concerns of specific patient groups—is a natural evolution.

Social media: this is where the public is talking about you

Part of his job is to monitor all online mentions of his medical centre and decide which ones are appropriate to respond to, and who should respond. “This is where conversations are moving, where they’re [the public] is talking about you, and if you don’t participate, you are cut off from the discussion.”

A lot of concerns are about services such as parking, or long waits in the ER, or how to get test results, he notes. “If you are able to resolve these, or just respond in a polite way, you can turn a negative into a positive.”

Craig Thompson, director of digital communications at Women’s College Hospital in Toronto, says  the  “low hanging fruit”  that  social media can address involves better communication about issues that frequently frustrate patients, such as hospital access and how to prepare for procedures.  Beyond that, opportunities to use social media to improve patient experience “present themselves at different times, every organization has to find its own solutions.”

Social media such as facebook also present the opportunity to create “extensions of real life face-to-face patient support groups,” says Bennett. The Maryland University Medical System sponsors four or five of such groups, including for transplant and for trauma patients; participants have to be invited to join (the groups are closed) and the groups are moderated by a health care professional.

“Still, we explain that nothing on the Internet is 100% closed and warn people not to put out any information that wouldn’t be comfortable with the world seeing,” he says.

The multiple channel approach

Michelle Hamilton-Page is the manager of social media at CAMH (the Centre for Addiction and Mental Health in Toronto), which has a multiple channel model approach to social media (see, for example, its foundation-associated endstigma facebook page).

Hamilton-Page’s position is based in education, rather than communications, and she spends much of her time helping groups within CAMH think through whether social media can help them meet their objectives and, if so, how to go about it.

A similar approach is taken at St. Michael’s Hospital in Toronto, notes digital media manager Anthony Lucic. “People think of social media as mass communication, but it can be really focused and targeted. Sometimes, it’s about just wanting to talk with a core group of peers. Our approach is very grassroots, we sit down with people to find out who they want to engage, and what networks they could use.”

Children’s Hospitals have been early adopters of social media

Children’s Hospitals, like CHEO in Ottawa and the SickKids (the Hospital for Sick Children) in Toronto, are among the most advanced in terms of using social media. That’s partly because the patients, and their parents, are younger—and members of age cohorts that are relatively more comfortable using social media.

“Our patients, and their parents, have different expectations” compared to adult hospitals, says Ann Fuller, public relations director at CHEO. “New generations are used to sharing more and have different expectations of privacy than my mother did.”

And Fuller notes some doctors are saying it is time to relook at the idea that that physicians should not interact through social media with patients, point to “niche applications” where, for example, a clinician could be on facebook with a group of young patients with diabetes.

A recent research study at CHEO into patients’ use of facebook underscored its importance to teenagers with long-term and chronic illnesses and noted that only a few disclosed any personal health information on their facebook pages.

It concluded that that the need for social-network-based communication between patients and healthcare providers—now forbidden by some institutions—will increase and that “age-appropriate privacy-awareness education” should be strengthened.

Calls for more education, literacy

Better education about social media is something that Sivan Keren Young, manager of digital communications at Sunnybrook Health Sciences Centre, thinks is essential. “Everyone is using social media, but no one gets any social media literacy training, there’s nothing in schools, and that can cause mistakes, people can unintentionally do the wrong thing.”

Interestingly, it was disappointment about the level of public uptake for H1N1 vaccination was the inspiration for the first major Canadian examination of how health care institutions could use social media to understand and improve the patient experience.

“For us, the light bulb went on” when the Toronto-based Health Strategy Innovation Cell went online to find out what was being said in patient websites and chat rooms about the H1N1 vaccine, says Cathy Fooks, president of The Change Foundation , which co-authored a report on using social media to improve health care and worked with two health care organizations to explore the potential of social media.

What the investigators discovered was a whole series of anti-vaccination conversations about concerns about the vaccine—concerns that were inhibiting people from getting vaccination. “Public Health had no idea—none of that concern had turned up in their formal communication channels,” Fooks noted.

The foundation went on to co-author with the Innovation Cell a seminal report on using social media to improve health care and a report based on work with two health care organizations exploring the potential of using social media.

According to Bennett, those who are still sceptical about social media should stop thinking of it as brand new and different: “It’s still people talking to each other.”

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25 comments

  1. Paul Gallant, CHE

    Thank you for posting this article. I hope it reaches many health providers, citizens and leaders who can become increasingly informed of the value of social media in hospitals and health authorities. As an early adopter myself, the evidence is now becoming increasingly clear on the value of social media when done right. As a Canadian and person concerned about the future of healthcare I think it’s part of my role and that of many Canadians to help inform health providers of the value that social media can provide. If your hospital or health authority is of yet there. I feel it’s now time to ask them/us why not?

    • Douglas McCarthy

      Another area in which social media can play a positive role is when a patient or a family member creates a virtual support group by keeping friends and family updated on the patient’s hospitalization and recovery via Facebook. I recently experienced this first hand when a friend’s son posted on his father’s Facebook account on his behalf, alerting us to his father’s condition and allowing us to express support and encouragement. The son also alerted us when his father was tired and did not want to see visitors. This would be fruitful area for research to determine under what circumstances social media can play a constructive role in supporting patient well-being.

  2. Angel Hoffman

    Great article to inform health care providers of the value of social media in quality health care and responsiveness to patients.

    Angela (Angel) M. Hoffman – Healthcare Compliance Expert

    Greater Pittsburgh Area
    http://aphccompliance.com
    angelataphccompliancedotcom

  3. Bob Ransom Outcubed Inc.

    Great Article, Hospitals have to get their feet wet in Social. Patients are collecting information and need to be lead on quality information by institutions. There is too much crap on the internet. Our hospitals have trust and credibility, the need to tweet and facebook with focus.

    We have been talking with UK hospitals on how to make money with social. One out of two outpatients are a potential source of monthly revenue. We are so far behind!

  4. Colleen Young (@colleen_young)

    I’m sorry to see that #hcsmca (health care social media Canada) didn’t make it into the article. #hcsmca is a community of practice. Community members use social media to talk about and explore innovative ways to use social media in health care. Many of the people interviewed for this article are regular contributor’s to the weekly #hcsmca tweetchats (Wed. 1pm ET), moderators and hcsmca blog authors.

    In this burgeoning world of social media, learning is constantly evolving at a pace that challenges school curricula and renders reports outdated very quickly. To Sivan Keren Young’s comment about education and social media literacy, I invite all readers to join the #hcsmca chats where you’ll find we learn, we educate and we build on the shoulders of each other’s experience, every day, every week.

  5. Dr Soji Ijidale

    This is a great one, coming at this time.%featured% Unfortunately,most health care providers and patients, here in Nigeria, still have a mindset of the social media as a public domain,where private health matters should not be discussed. %featured%I think the point here is education. Most users of the social media do not have any pre- education about the use of the network,therefore abuse or unintentional misuse may be unavoidable. But methinks social media use is about communication,and this is not only important for enhanced interface between the provider and the patients, it helps and quickens management of the patients’ care. I look forward to a day when the use of social media will become the norm among health care providers and their patients in Nigeria. Good work you have done!

  6. Max Eckbo Hallqvist

    I have been working within a workshop for Health and Wealth in the worlds largest international studentfestival (ISFiT), and it is so good to see that new idées which we have discussed are being focused on in other forums as well.

  7. Ann Fuller

    This topic topic is so rich in healthy debates, that I’m looking forward to reading more on it here. 🙂

    And #hcsmca is definitely a great resource Colleen. It is kind of like a “home base” for discussion, crowdsourcing and an exchange of best practices.

  8. Craig Thompson

    As Ann Fuller said, this is an area rich in healthy debate which I why I too recommend the weekly #hcsmca Twitter chats under the stewardship of Colleen Young. It’s an inclusive and welcoming forum in which to discuss, debate and defend social media’s place in healthcare. The more we share our experiences (good and bad) using social media the better it will be for health systems everywhere.

    • Michelle Hamilton-Page

      Agreed! In the world of emerging practices, a facilitated network like #HCSMCA is invaluable as we make our way forward, fail fast, and identify what is becoming promising practice.

  9. Ron Wray

    %featured%What is disconcerting about the rise of the social media in thought and implementation is the lack of attention to the issue of health equity.%featured% There are clearly social and/or economic class differences in social media access, capacity and utilization. One does not have to stretch too far to suggest that most discussions are “middle class” oriented.

    Although now dated in terms of the technology focus (a decade old and focused on desk top computer and internet), a seminal article on the issue of technology equity helps frame the discussion with sociological concepts that remain pertinent even as we move to mHealth etc.

    From the ‘Digital Divide’ to ‘Digital Inequality’: Studying Internet Use as Penetration Increases

    “…..students of inequality of access to the new information technologies should shift their attention from the “digital divide” — ine-quality between “haves” and “have-nots” differentiated by dichotomous measures of access to or use of the new technologies — to digital inequality, by which we refer not just to differences in access, but also to inequality among persons with formal access to the Internet. After reviewing data on Internet penetration, we describe five dimensions of digital inequality — 1) in equipment, 2) autonomy of use, 3) skill, 4) social support, and 5) the purposes for which the technology is employed — that we believe deserve additional attention”.

    https://www.princeton.edu/~artspol/workpap/WP15%20-%20DiMaggio%2BHargittai.pdf

    If the scope of social media discussion does not explicitly challenge ‘digital inequality’ there is good reason to believe the outcome will be increased health inequality.

  10. moses Igbafe

    To the friend from Nigeria, I am curious to know what what impact the old colonial law against advertising AND the currently proposed Health Bill will have on Social media potential use by Health providers.

  11. RunningLate

    Here’s a great example of the use of social media to improve patient experience.
    The Runninglate patient notification service lets doctors or heir receptionist tweet their on-time status to their patients through twitter. http://www.runninglate.co.za

    Patients are already on Twitter and there is no better way to maintain an open communication channel!

  12. Erick Kinuthia

    Great post Ann. Despite being used to improve patient experience,social media also plays a major role in marketing of medical services and doctors cannot overlook this provision.

    Erick Kinuthia
    Team MDwebpro.com

  13. Dr. Vinay B. Bahl

    It is very informative article and infact never discussed by the hospital authorities for the role of Social media . Social media definitely plays a big role in hospital promotional activities. New born care , Pregnant mother care and junk food and many such articles published by different hospitals and doctors have proved to be very useful among masses.

  14. Darrel

    Great article. But I wonder, is there a way that Social media at hospital can reduce no-shows while taking the patients’ privacy in mind?

  15. Russell

    This is more of an advertisement than a factual article. The older generation its not Tweeting. This does mention a move by government-run medicine to remove social media complaints. Since patients are a ‘captive’ service population do you honestly believe government run healthcare worries about your opinion? What is your option if you are unhappy?

  16. Terry Hannan

    These comments give much credence to the ides written in the book “The Wisdom of Crowds”. The availability of these newe technologies for patients (one for every memebr of the community) allows them to direct thier own care. A strong move away from the error-prone, hopsital-specialist based current care models. Also very supportive of this movement is “Care without the doctor” from the Californian Health Care Foundation.

  17. E Hudson

    Yes we are now in the age of Social Media – Good or Bad – Privacy is the main loss – but as the article notes – ‘ Ed Bennett, who manages web operations at the University of Maryland Medical System’ – is operating in the USA not Canada – I am pleased to see that Canada and Canadian Hospitals are becoming part of the discussion and yes, to some of the issues, on social media, it would be good for some to respond to the questions raised, eg Parking, etc. But where I live, if I need a procedure, I do not choose the hospital where I am going to get the procedure done, that is chosen for me and I am told where and when to respond – That is one of the main differences in the situation here

  18. Chris

    The older generation may not be Tweeting, but I am. And I am making decisions about where my 85yo mother receives her care. Health care in the US is now more than ever judged by not only their outcomes, but their service. Although in Canada the government may not care, the impact of multiple negative comments may be there – just unseen to the public.

  19. Lejla Tukici

    Very nice article.very interesting topic…
    In my opinion in health care industry is important to get hired people who love and they are dedicated to this profession.we have to start from here….

  20. Charles Morse

    WOW! %featured%This article and the comments posted expose a huge potential for not only the healthcare industry, but the population as a whole.%featured% I can’t wait to see and “hear” what develops on the horizon.

  21. Julio

    In Spain, there is http://www.observatics.com where you can find all spanish hospital and it relationship with social networks. It has stats and charts of the use of YouTube, Facebook and Twitter tool for each hospital.

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