Social media provides a vibrant tool for marketing products and services to targeted consumers but allows only loose control of the information.The use of social media by physicians and health care institutions is becoming more complex and varied, as it is in the rest of society. All types of social media are penetrating the health care market—sometimes in surprising ways.
According to Kaplan and Haenlein (Business Horiz. 2010;53:59-68), social media is a collection of Internet-based applications that build on the ideological and technological foundations of Web 2.0 and allow the creation and exchange of user-generated content. They incorporate technologies such as Adobe flash player, which allows for audio and video streaming; really simple syndication (RSS), which allows standardization of publications such as blogs; and asynchronous JavaScript and XML (AJAX), which allow retrieval of data from web servers without changing the display or functions of the page being displayed.
Social media content is end user-generated and must be published on a publicly accessible website, must show a certain amount of creative effort by the end user and, finally, must have been created by a non-professional. The use of these sites has increased markedly over the past 10 years and is starting to penetrate all aspects of health care.
Examples of popular social media are Facebook, Myspace, YouTube, Twitter, Wikipedia, WikiLeaks and Ventrilo. MySpace and Facebook, launched in 2003 and 2004, are in use worldwide. Europe and Asia lead the world in Facebook accounts, at around 240 million apiece. As of the first quarter of 2012, there were 835 million Facebook accounts. Myspace has had similar growth rates. Many physicians and hospitals have Facebook accounts and use them to connect with their patients, with varying degrees of success.
Our own Academy has a Facebook page with 3,762 likes and a Twitter account with 2,697 followers. As with all social media, there is a broad spectrum of users, though younger members are generally more active. LinkedIn is also used by the staff and membership, albeit with volumes only in the low 400s.
YouTube statistics are even more staggering: Every minute, 72 hours of video are uploaded; four billion hours of video are watched every month, and in 2011, YouTube had more than one trillion views—around 140 views for every person on Earth. This has all been accomplished since 2007, a mere six years ago. YouTube distributes 500 years’ worth of video every day through Facebook, and 700 YouTube videos are tweeted every minute. Who could have envisioned these technologies or volumes 10 years ago?
User Ratings
So how is social media penetrating the medical profession and its institutions? Just as it is in other areas of society—in just about every conceivable way and with widely variable effects.
Health care institutions that embrace social media have to deal with a double-edged sword: Social media provides a vibrant tool for marketing products and services to targeted patients but, at the same time, allows the institutions only loose control of the information. If a product or service is viewed negatively, the freelance contributors of social media can do a lot of damage. A dissatisfied patient now has a platform to complain not to 10 but to 10 million customers. Institutions have incorporated complaint centers on their own websites to bring issues to light and resolve them quickly, before the damage is beyond control.
An example of this principle is the dynamic rating tools that have permeated product marketing on the Internet. Social media has rendered businesses essentially powerless to control their own public images. The same thing can occur in medicine and, let’s face it, the competitive health care market is big business.
Sixty-eight percent of the 25 largest hospital systems in the U.S., as measured by number of employees, have a social media presence, but only 10 of the 25 largest systems had more than 500 Facebook likes. (This makes our Academy look pretty good.)
Successful Use in Health Care
Examples of hospitals successfully using social media include Facebook pages targeting pregnant mothers, pediatric issues and families of cancer patients. A children’s hospital might use Facebook likes and Twitter followers for fundraising, i.e., $1.00 donated for each like or follower, with a goal of $100,000. Parents of patients are able to share their stories—and, fortunately, most are positive.
As with other businesses, however, there is little control over negative input. Some systems effectively use Twitter as a platform for job postings. Others use it to encourage questions, with answers posted back on Twitter and archived in Q&A pages on the organizations’ websites.
Blogs are also very effective, but underutilized, tools for reaching a target audience. Only three of the largest 25 hospitals effectively utilize blogs at all. One of these hospitals started a blog in response to patients who had been blogging their dissatisfaction with the system.
The key to making these systems effective is staff dedicated to maintaining and responding to inquiries. Without this staff, patient or consumer impressions of the organization can be devastating.
In my next column, we will explore how physicians are incorporating social media into their practices.
Rodney Lusk, MD, is director of the Boys Town Ear, Nose and Throat Clinic and Cochlear Implant Center at Boys Town National Research Hospital in Omaha, Neb. He has been working with EMRs since 1996. He may be reached at rodney.lusk@boystown.org.