On 2/4/14, I presented a talk at Memorial Sloan-Kettering Cancer Center "Connectivity, Collaboration, and Disruption: Social Media and the Oncologist." I created a special hashtag - #msk_hcsm14 and used it to schedule a series of tweets to go out during the talk with some of my references.
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Connectivity, Collaboration, and Disruption: Social Media and the Oncologist
1. #msk_hcsm14
Connectivity, Collaboration, and Disruption:
Social Media and the Oncologist
Solid Tumor Conference
Memorial Sloan-Kettering Cancer Center
February 4, 2014
Robert S. Miller, MD, FACP, FASCO
Clinical Associate, Breast Cancer Program
Johns Hopkins University School of Medicine
Oncology Medical Information Officer
Sidney Kimmel Comprehensive Cancer Center
6. #msk_hcsm14
Social
 media
 is
 user
 generated
 content
 that
 is
 shared
 over
 the
Â
internet
 via
 technologies
 that
 promote
 engagement,
 sharing
 and
 collabora8on.*
Â
*
 DeïŹni(on
 from
 The
 Social
 Media
 Guide.com
Â
weill.cornell.edu
Â
7. Social
 media
 is
 the
 second
 Internet
 revolu8on.
Â
Â
#msk_hcsm14
Used
 w/
 permissions
 GNU
 License
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h;p://en.wikiversity.org/wiki/File:Web_2.0_elements.png
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h;p://en.wikiversity.org/wiki/File:Web_1.0_elements.png
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weill.cornell.edu
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18. #msk_hcsm14
Patient engagement and
empowerment - trends
1.⯠The rise of the e-patient
--democratization of medical information
2.⯠Patient portals/online access to medical records =
part of Meaningful Use
3.⯠Patients online and engaged in social media (long
before physicians)
4.⯠Peer-to-peer healthcare
20. #msk_hcsm14
U.S.: Different sources for different information
http://www.pewinternet.org/Presentations/2013/Jul/Epatients-and-their-hunt-for-health-information.aspx
21. #msk_hcsm14
Mobile health
âï⯠91% of U.S. adults own cell phones
âï⯠56% of U.S. adults own smartphones
âï⯠19% of smartphone owners use health
apps
âïâŻSelf-tracking/âQuantified self â
âïâŻExercise, fitness, pedometer, pulse monitoring,
BP, diet, food/calories, blood sugar, mood,
sleep
22. #msk_hcsm14
http://www.jmir.org/2013/12/e287
1.⯠295 unique apps
2.⯠Purpose: raise awareness (32%), educational
info about cancer (29%), early detection
(12%), fundraising (10%), support disease
management (4%), prevention (2%)
3.⯠Few apps took advantage of smartphone
capabilities (no mobile sensing, limited
communication w/ medical team, other pts)
4.⯠0/594 articles w/evaluation of cancer app
26. #msk_hcsm14
3
 ways
 physicians
 might
 use
 social
 media
Â
1.⯠To
 treat
 â
 engaging
 directly
 w/
 pa8ents
 about
 care
Â
2.⯠To
 teach
 â
 providing
 8mely
 &
 credible
 educa8on
Â
3.⯠To
 learn
 â
 sharing
 of
 medical
 informa8on/knowledge
Â
Â
Bucket
 1
Â
Bucket
 2
Â
Bucket
 3
Â
28. #msk_hcsm14
The
 âMeaningful
 Useâ
 of
Â
Â
Social
 Media
 by
 Physicians
Â
Brian
 S.
 McGowan,
 Ph.D.
Â
Â
Senior
 Director,
 Oncology;
Â
Â
Medical
 EducaDon
 Group,
 PïŹzer
 Inc
Â
Chair,
 Commi;ee
 on
 Emerging
 Technologies
 in
 Educa8on
Â
Alliance
 for
 Con8nuing
 Medical
 Educa8on
Â
Consult
 Columnist,
 Social
 Media
 Connec(ons
Â
Medical
 Mee8ngs,
 A
 Mee8ngsNet
 Magazine
Â
Presented
 at
 âMedicine
 2.0â
 September,
 2011,
 Stanford,
 CA
Â
29. #msk_hcsm14
DeïŹning
 âSharing
 Medical
 Informa8onâ
Â
âąâŻ Sharing
 medical
 knowledge
 is
Â
deïŹned
 as
 the
 exchange
 of
Â
informa(on,
 advice,
 ideas,
Â
reports
 and
 scien(ïŹc
Â
discoveries
 with
 other
Â
physicians
 in
 the
 medical
Â
community.
Â
Â
Â
Â
Â
Bucket
 3
Â
30. #msk_hcsm14
Adopters
 versus
 Adamant
 Non-ÂâAdopters
Â
%
 of
 Physicians
Â
80
Â
71
Â
70
Â
60
Â
52
Â
50
Â
40
Â
33
Â
30
Â
20
Â
10
Â
13
Â
6
Â
40
Â
36
Â
27
Â
26
Â
25
Â
23
Â
21
Â
19
Â
19
 21
Â
18
Â
16
Â
16
Â
13
Â
11
Â
11
Â
9
Â
7
Â
0
Â
Will
 Never
 Use
Â
Current
 user
Â
9
Â
5
Â
1
Â
31. #msk_hcsm14
http://www.jmir.org/2012/5/e117
âąâŻ 24% use SM daily to explore/share medical
information; 14% use SM daily to
contribute
âąâŻ 60% say SM improves quality of pt care
âąâŻ Oncologists more likely to use SM due to
âpersonal innovativenessâ
âąâŻ PCPâs more likely to use SM to have access
to peers
37. #msk_hcsm14
Why I like Twitter
âï⯠Low barrier to entry
âï⯠Platform agnostic
âï⯠Minimal requirements for content production (140-
character tweets vs. 500-word blog posts)
âï⯠Emphasis on frequency, breadth not depth
âï⯠Asymmetric (âfollowingâ does not require
reciprocation)
âï⯠Ability to embed shortened links
âï⯠#hashtags = metadata
âï⯠Instantaneous dissemination of information
39. #msk_hcsm14
Diagram of a Tweet
â@â + username
calls that userâs
attention to
message
âshortenedâ
link
Actions you can
take after posting
Science at the heart of medicine
# Hashtags =
easier way to find
groups of tweets
| 39
40. #msk_hcsm14
#Tweetchats
âï⯠Virtual meetings usually held on a repeating basis
organized around a specific topic and hashtag
âï⯠Healthcare Hashtag Project -
http://www.symplur.com/healthcare-hashtags
âï⯠#BCSM = Breast Cancer Social Media (Mon 9 pm ET)
âï⯠Moderated by 2 breast cancer advocates @jodyms & @stales
and an LA breast surgeon @DrAttai
43. #msk_hcsm14
Je nâai fait celle-ci plus longue que
parce que je nâai pas eu le loisir de la
faire plus courte.
--Blaise Pascal, Lettres Provinciales (1657)
âI would have written a shorter letter,
but I did not have the time.â
46. #msk_hcsm14
How I use Twitter - inbound
âï⯠Twitter accounts I follow:
§ï§âŻ Oncologists & other MDâs
§ï§âŻ Thought leaders in organized medicine & IT
§ï§âŻ Journalists, bloggers, patient advocates, public figures
§ï§âŻ Professional societies, institutions
§ï§âŻ Not necessarily everyone who follows me
âï⯠New insights â patient empowerment, patient-centered
health IT, safety/quality
âï⯠New professional opportunities (but not academic
advancementâŠyet)
48. #msk_hcsm14
Consider the value:
âï⯠Unexpected connections & networking
âï⯠Crowdsourcing questions
âï⯠Establishing own digital footprint/reputation
management
âï⯠Promote your science
49. PLoS Biol. 2013 April; 11(4): e1001535
â In the age of the internet, social media tools
offer a powerful way for scientists to boost their
professional profile and act as a public voice for
science.â
â[I]n todayâs technology-driven world, lack of an
online presence can severely limit a researcherâs
visibility, and runs the risk that undesirable search
results appear before desirable onesâŠâ
50. How and why to use social media as
a scientist
âï⯠Online tools improve research efficiency
§ï§âŻ Keeping up with new developments via Twitter
§ï§âŻ Online communities for niche topics
§ï§âŻ Blogs as medium for extended scientific conversations
âï⯠An active online presence may enhance credentials
measured through traditional metrics
âï⯠Social media enhances professional networking
âï⯠Communicating science to the general public
§ï§âŻ To patients/lay audience â teach, translate
§ï§âŻ Combat pseudoscience (vaccine/autism example)
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3635859
52. #msk_hcsm14
Twitter usage at ASCO Annual Meeting
âï⯠#ASCO10: 684 users, 4456 tweets (14 MDâs=979 tweets)
#ASCO11: 1537 users, 8188 tweets (34 MDâs=1477 tweets)
Chaudhry A, Glode LM, Gillman M, Miller RS (2012). Trends in Twitter use by physicians at the American Society of Clinical
Oncology Annual Meeting, 2010 and 2011. J Oncol Pract 8:173-178.
http://jop.ascopubs.org/content/8/3/173.full
57. #msk_hcsm14
Social media & clinical trials
âï⯠Engage your institutionâs media department and the
sponsor before creating Facebook page/Twitter account
âï⯠Determine if IRB review required
âï⯠No proprietary information
âï⯠Avoid claims about efficacy or discussion about side effects
âï⯠No disclosure of trial results
âï⯠Monitor posts to avoid HIPAA violations
âï⯠No screening of subjects via social media
âï⯠Link only to sites for more info (e.g., clinicaltrials.gov)
âï⯠No blogging about conduct of study (can be viewed as
advertising)
Adapted from Table 3 in Dizon DS et al J Oncol Pract Sep 1, 2012:e114-e124
59. #msk_hcsm14
Professionalism in the Use of Social Media
(AMA Policy 11/8/10)
âï⯠Always maintain patient privacy/confidentiality.
âï⯠Monitor own Internet presence/use privacy settings
on SM (know they are not absolute).
âï⯠Maintain boundaries when interacting with patients
online.
âï⯠Consider separating personal & professional online
accounts.
âï⯠Police colleaguesâ online behavior.
âï⯠Online behavior can affect reputation & undermine
trust in the medical profession.
http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medicalethics/opinion9124.page
62. #msk_hcsm14
Potential problem areas
âï⯠Establishing a patient-physician relationship via social
media
âï⯠Communicating directly with existing patients via
social media/online friendships and connections
âï⯠Writing about patients on social media
âï⯠Googling patients
âï⯠Product endorsements and advertisements
Chretien K, Kind T. Social media and clinical care: Ethical, professional, and social
implications. Circulation 2013; 127:1413-1421
http://circ.ahajournals.org/content/127/13/1413
63. #msk_hcsm14
Ten tips from ASCO (Tips 1-5)
1.⯠Get involved
2.⯠Engage often
3.⯠Always identify yourself
4.⯠Protect patient confidentiality and
privacy
5.⯠Contextualize your activities
64. #msk_hcsm14
Ten TipsâŠ.
6.⯠Avoid impropriety
7.⯠Give credit where credit is due
7.⯠Professionalism is critical
8.⯠Separate the personal from professional
9.⯠Be aware of your institutional guidelines
http://www.asco.org/about-asco/social-media
65. #msk_hcsm14
Mayo Clinic
12 Word Social Media Policy
âï⯠Donât Lie, Donât Pry
âï⯠Donât Cheat, Canât Delete
âï⯠Donât Steal, Donât Reveal
--Farris Timimi, M.D., Medical Director, Mayo Clinic Center for Social Media
http://socialmedia.mayoclinic.org/2012/04/05/a-twelve-word-social-media-policy
66. #msk_hcsm14
My versionâŠ
âï⯠Donât be anonymous
âï⯠Donât be stupid
âï⯠Remember everyoneâs watching
âï⯠Developing trust in your online community takes time
â maintain a healthy skepticism
68. #msk_hcsm14
How to get started
âï⯠Be a lurker first
§ï§âŻ Read blogs, listen to podcasts, learn how to use RSS feeds for journals & news sites
âï⯠Join Twitter
§ï§âŻ Pick a short, descriptive handle, use a real photo as an avatar
§ï§âŻ âWho to followâ Twitter suggestions, follow people others follow
§ï§âŻ Give it time to grow
âï⯠Share content â links to articles and stories that
interest you
âï⯠Create content â blog
âï⯠Cultivate your network â RTâs, #FF, @replies
69. Public network skills every physician
should have --Bryan Vartabedian, MD (33 charts
blog)
1.⯠The ability to confidently shape and compose an idea
2.âŻ
3.âŻ
4.âŻ
5.âŻ
or opinion in under 500 words
The ability to summarize and share an idea in a few
hundred characters
The ability to shape an idea and put it on a short
video clip
Understanding of the limitations of patient-specific
dialog in public networks
Understanding of how to manage input and
consumption of information
http://33charts.com/2013/09/public-network-skills-physicians.html
70. New physician literacies in the digital
age --Bryan Vartabedian, MD (33 charts blog)
1.⯠Network Awareness/Collaboration
-Physicians no longer control information
2.⯠Input management
-Too much to know (balancing information, attention, and
filters)
3.⯠Creation/Translation
-Moving online from
observationĂ ï conversationĂ ï curationĂ ï content creation
4.⯠Mindfulness
-Balancing technology with attention to patients
http://33charts.com/2012/09/new-physician-literacies.html
71. #msk_hcsm14
Conclusions
âï⯠The Internet has democratized information and
eliminated traditional filters constraining access to
medical knowledge; social media (SM) is the
communication channel resulting from this change in
paradigm.
âï⯠SM provides an unparalleled opportunity for the
authoritative voice of the physician to be heard in patient
education & health messaging.
âï⯠Physicians can effectively use SM for connection and
networking with other physicians and scientists both inside
of and outside of traditional spheres of influence.
72. #msk_hcsm14
Conclusions (cont.)
âï⯠Concerns about patient privacy, liability, and time
commitment do not negate the value of participation in
SM.
âï⯠Physician professionalism and patient-centered focus
trump all other considerations.
73. Track this talk on Twitter
#msk_hcsm14
Follow me on Twitter:
@rsm2800
Read my blog:
rsm2800.blogspot.com