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The Social Media Imperative
Lee Aase and Farris Timimi, M.D.
Mayo Clinic Center for Social Media
May 17, 2012
#HCSMNY
Agenda
• Mayo Clinic’s Social Media History
• Two Societal Indicatives
• Eight Health Care Social Media Imperatives
A Brief History of Social Media
at Mayo Clinic
Mayo Clinic’s First Social Networkers
Sources Influencing Preference
for Mayo Clinic
     Word of mouth                                                             82
       News stories                                              62
    Hospital ratings                                   48
            Internet                         33
MD recommendation                         29
Personal experience                     26
        Advertising                    25
         Direct mail           13
       Social media       5
                                                            2010 study (n=119)
     Insurance plan       5



                       Consumer Brand Monitor, Base: Respondents who prefer Mayo Clinic;
                                                        *differs significantly from Q2-2010
                                                                                     ©2011 MFMER | slide-20
Mayo Clinic Medical Edge
Syndicated News Media Resources
First Foray in “New” Media




• Existing Medical Edge radio mp3s
• Launched Sept. ‘05; 8,217% download increase
Regrouping to Plan
Just as genomics is the future of personalized
medicine, personalized media are changing the
way people get the news and information they
want and need. But as genomics increasingly
supplements and improves traditional medicine
without replacing it, new media are helpful
additions to mainstream, mass media. We strongly
recommend reforming our processes to efficiently
produce content that can be used for both mass
media and personalized media.


          Content Creation Task Force, 7/26/2006
We recommend a three-phase approach. First, take
our existing products and, with minimum
incremental effort, place them in new media formats.
Second... work across teams ... to make best use of
the audio and video production resources we have.
Third, get more resources... to produce timely or
even daily content...

We have not recommended a blog strategy at this
time, primarily because we have emphasized
developing audio and video content that could have
multiple uses in both mass media and personalized
media, with relatively limited physician involvement.
Reasons for Reluctance about Blogging
• Keeping the content fresh
• Wise use of resources
  • Physician/Researcher
  • Public Affairs
• Authenticity - didn’t want to “ghost blog”
My First Blog Post - 7/30/06
Lines from Lee
Beyond the Hypochondriac Feed
Mayo Clinic Medical Edge TV
Sample Sound Bite
Recovering 99.41% for the 1-2%

  • Required almost no incremental MD effort
  • Process change - microphone on physician
    and interviewer
  • 90 minutes of editing per interview
  • More than 60,000 “hits” and 62 comments on
    Dr. Fischer’s podcast
Involuntary Social Networking Presence:
http://myspace.com/mayoclinic
Facebook: 11/7/07
A Pivotal Presentation
Getting on YouTube: Feb. ’08
Joining The Blog Council
• Membership organization of blogging
  “companies”
• Typically Fortune 500 members
   • Coca-Cola, P&G, Wells Fargo, etc.
   • Mayo Clinic, Kaiser Permanente, U.S. Navy
    among “non-traditional” members
• Now the Social Media Business Council
Transforming YouTube Channel
Podcast Blog: April ’08
@MayoClinic on Twitter: 4/29/08
Let’s Talk “site” - May 2008
Sharing Mayo Clinic - Jan. 2009
http://connect.mayoclinic.org/
http://network.socialmedia.mayoclinic.org/




                                             ©2011 MFMER | 3139261-
A Grammar Refresher on Verb Moods...
• Indicatives - express a simple statement of fact
• Imperatives - express a command or exhortation
The Millennial
Indicative
Millennials
• Characterized by an increased use and
  familiarity with digital technology, social media
  and communication
• With Median age of the world's population about
  29, half were born in 1983 or later
Millennials
• 26 percent more likely than other adults to say
  “Social Networking is an important part of my
  everyday life”
• 2010 research: students quitting social media
  showed same withdrawal symptoms as a drug
  addict who quit a stimulant
Survey of college students born 1982–1992
•   97% owned a computer
•   94% owned a cell phone
•   56% owned an MP3 player
•   76% used instant messaging
•   92% of those reported multitasking while instant
    messaging
• 40% got most of their news from TV
• 34% got most of their news the Internet
The Mass Media Malaise
Indicative
The Media Relations
Imperative
The Octogenarian Idol Story
• Alerted to interesting video of elderly couple
  playing piano in Gonda atrium
• Video shot by another patient and uploaded to
  YouTube by her daughter
• Video had been seen 1,005 times in six
  preceding months since upload
• Embedded in Sharing Mayo Clinic, posted to
  Facebook, Tweeted on 4/7/09
The next day...
Six days later...
April 22
Sunday, May 3
May 4
Cinco de Mayo
May 10
May 11
May 12
May 15
Early Morning May 26
May 26, 2009: Live in Studio
Good Morning America
Results to Date
•   More than 8 million views on YouTube
•   >1.5 million views on Sharing Mayo Clinic
•   From 200 views/month to 5,000 views/hour
•   National TV coverage in U.S. and Japan
#26: Your mileage may vary,
but you’ll go a lot further if you
get a car
The $4-a-month online newsroom
The Marketing
Imperative
Unique Myelofibrosis Patients
                MCF           MCA

   400

   300

   200

   100

     0
         2008   2009   2010         2011
Discovery by Richard Berger, M.D., Ph.D.
Ulnotriquetral (UT) Ligament Split Tear
Jayson Werth’s Experience
Nov 12, 2009
USA Today




               3031031-7
Last Friday




              3031031-9
Less than 24 hours after my initial appointment, I not
  only had a new diagnosis - a UT split tear - but had
  surgery to correct the problem. As I write this, my
     right arm is in a festive green, but otherwise
   annoying cast. The short-term hassle, however,
 should be more than worth the long-term gain - the
  potential for a future without chronic wrist pain. A
 future, that without Twitter and those in the medical
      community willing to experiment with new
    communications tools, might not exist for me.




                                                     3031031-10
UT Split Repair Procedures


                                             40

                                            30

                                            20

                                        10
2007
       2008                             0
              2009
                       2010
                                 2011
The Mobile
Imperative
bit.ly/GetMayoApp
The Management
Imperative
Maybe Unfamiliar, Not Unfathomable
©2011 MFMER | 3139261-
The Medical Practice
Imperative
Dr. Sreenivas Koka
Dr. Sreenivas Koka
The Medical Education
Imperative
Medical Education
• Duty Hours: Reduce resident fatigue: 1984, NY,
  death of an 18 yr from potentially preventable
  drug interaction, when only 2 residents assigned
  to provide night coverage for night a busy
  hospital
• An 80-hour limit to the work week was imposed
  on New York programs shortly thereafter.
Medical Education
• 80-hour weekly limit, averaged over 4 weeks
• 10-hour rest period between duty periods and
  after in-house call
• Maximum continuous duty period for G1s 16
  hours
• One day in 7 free from patient care and
  educational obligations, averaged over 4 weeks
• In-house call no more than once every 3 nights
Program Director Survey
• Do you think the duty-hour regulations have an
  adverse impact on your ability to educate your
  residents?
   • 57% indicated it did
Resident Surveys
• Less time for formal educational activities/
    conferences
•   Less time for informal education
•   Less time for ambulatory training
•   Loss of continuity of care (more handoffs)
•   Less time at bedside
Medical Education
• Fundamentally, social media tools serve two
  educational goals
  • Facilitate asynchronous geographically
    disparate encounters
  • Facilitates Social Constructivism: Learning
    where individuals engage around a task or
    problem
Medical Education-Four Cs
• Content-Rapid and transparent online access
• Creation-Just as in health care, scalable
  leveraging occurs in learning as well
• Connection-Networking, facile in practice begins
  in training
• Collaboration-Participate where patients,
  providers, fellow learners and educators are
Medical Education
• Closed Facebook group for a medical resident
  clinic-fosters group expectations and notification
• Tweeting national meetings: Leveraging
  education and networking opportunities
Medical Education
• Discussion Forums-SDN-40,000 active
  members, over 2 million unique visits and 12
  million page views monthly
• Wikis-Resident created and curated
• Blog-Asynchronous education with social media
  feedback
Medical Education
• Fundamentally, our learners represent the first
  generation raised in an online era, mp3, iPad,
  iPhone and Twitter; and our educational
  recruitment, engagement and training must
  reflect this
The Medical Research
Imperative
Spontaneous Coronary Artery Dissection
SCAD?




Findings being published in
 MAYO CLINIC
PROCEEDINGS
September 2011 issue




                                      ©2011 MFMER | 3139261-
The Moral
Imperative
Information Overload
•   PubMed-21 million citations, one new/min
•   Over 200 Cardiology journals
•   324 active diagnoses
•   Increasing online transparency and access
•   Does transactional clinical care pass the straight
    face test?
Not just information overload….
                                   Direct Care-20%
   Documentation-35%
                                              Assessment/
                                              Vitals-7%




      Medication-17%               Care Coordination-21%
             JONA, 39, 6:266-275
Moral Imperative
• Is it any wonder that 61% of us have sought
  knowledge and support online?
• The value of that interaction is purely dependent
  on two factors: access to the conversation and
  the quality of the knowledge shared
Moral Imperative
• Yet, all too often, care providers are absent from
  the patient conversations
   • “Don’t want to be sued!”
   • “Who will pay for my time online?”
   • “What about HIPAA?”
Moral Imperative
• We are all the lived experts of our own disease
• Media are evolving to the point that we all have
  access to the same shared knowledge
• Providers can be partners with patients and walk
  with them on their journey online and offline
• Providers can help shape the conversation,
  leverage information and ensure that credible
  content is available when patients need it
Vaccine Hesitancy
• Efficiency
  • Each discussion averages 5-10 mins
  • By 24 months, 14 vaccines in 8 visits
• Liability
  • Several law suits brought by parents whose
    children suffered from vaccine refusal
Vaccine Hesitancy
 • Risk
    • 13 years since Wakefield, dramatic drop in
     MMR vaccination in EU with a marked
     increase in measles and mumps
   • 2011-major measles outbreak in 33 EU
     countries, including 10,000 in France alone
   • US-80% of primary care providers report 1
     vaccine refusal per month; 8% of providers
     report 1 in 10 parents refused vaccine
Moral Imperative
• Physicians must partner with patients in content
  creation, curation and decision making
• Leverage the content, leverage the
  conversation, leverage the good
Moral Imperative
• Start small-begin with meaningful transactions
  • Good content made available to willing
    patients
• Develop clear training (2010 only 10% of
  medical schools offered social media policies)
  and clear guidelines for engagement
Moral Imperative
• Advocate for those who may be excluded
  • Remember the access angels, libraries,
      houses of worship
  •   Consider mobile capable information
  •   Remember the disabled and chronically ill
  •   Remember those with rare disease who
      geography isolates
Mayo Clinic CEO John Noseworthy, M.D.
Mayo Clinic Center for Social Media
• Our Raison d’etre: The Mayo Clinic Center for
  Social Media exists to improve health globally
  by accelerating effective application of social
  media tools throughout Mayo Clinic and
  spurring broader and deeper engagement in
  social media by hospitals, medical professionals
  and patients.
• Our Mission: Lead the social media revolution in
  health care, contributing to health and well
  being for people everywhere.
Social Media Health Network
• Membership group associated with Mayo Clinic
  Center for Social Media
• For organizations wanting to use social media to
  promote health, fight disease and improve
  health care
• Dues based on organization revenues
• Industry members eligible to join, but not
  accepting industry grant funding
• >110 member organizations
A Sample of Network Members
•   American Hospital Association
•   Radboud University Nijmegen Medical Center
•   Jamestown Hospital
•   National Cancer Institute
•   HCA
•   Vanderbilt University Medical Center
•   University of Michigan Medical Center
•   See Full List at http://socialmedia.mayoclinic.org/
    network/
For Further Interaction:
•   socialmediacenter@mayo.edu
•   http://socialmedia.mayoclinic.org
•   @LeeAase and @FarrisTimimi on Twitter
•   Keep tweeting at #HCSMNY

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The Social Media Imperative

  • 1. The Social Media Imperative Lee Aase and Farris Timimi, M.D. Mayo Clinic Center for Social Media May 17, 2012 #HCSMNY
  • 2. Agenda • Mayo Clinic’s Social Media History • Two Societal Indicatives • Eight Health Care Social Media Imperatives
  • 3. A Brief History of Social Media at Mayo Clinic
  • 4. Mayo Clinic’s First Social Networkers
  • 5. Sources Influencing Preference for Mayo Clinic Word of mouth 82 News stories 62 Hospital ratings 48 Internet 33 MD recommendation 29 Personal experience 26 Advertising 25 Direct mail 13 Social media 5 2010 study (n=119) Insurance plan 5 Consumer Brand Monitor, Base: Respondents who prefer Mayo Clinic; *differs significantly from Q2-2010 ©2011 MFMER | slide-20
  • 6. Mayo Clinic Medical Edge Syndicated News Media Resources
  • 7. First Foray in “New” Media • Existing Medical Edge radio mp3s • Launched Sept. ‘05; 8,217% download increase
  • 8. Regrouping to Plan Just as genomics is the future of personalized medicine, personalized media are changing the way people get the news and information they want and need. But as genomics increasingly supplements and improves traditional medicine without replacing it, new media are helpful additions to mainstream, mass media. We strongly recommend reforming our processes to efficiently produce content that can be used for both mass media and personalized media. Content Creation Task Force, 7/26/2006
  • 9. We recommend a three-phase approach. First, take our existing products and, with minimum incremental effort, place them in new media formats. Second... work across teams ... to make best use of the audio and video production resources we have. Third, get more resources... to produce timely or even daily content... We have not recommended a blog strategy at this time, primarily because we have emphasized developing audio and video content that could have multiple uses in both mass media and personalized media, with relatively limited physician involvement.
  • 10. Reasons for Reluctance about Blogging • Keeping the content fresh • Wise use of resources • Physician/Researcher • Public Affairs • Authenticity - didn’t want to “ghost blog”
  • 11. My First Blog Post - 7/30/06 Lines from Lee
  • 13. Mayo Clinic Medical Edge TV Sample Sound Bite
  • 14. Recovering 99.41% for the 1-2% • Required almost no incremental MD effort • Process change - microphone on physician and interviewer • 90 minutes of editing per interview • More than 60,000 “hits” and 62 comments on Dr. Fischer’s podcast
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  • 16. Involuntary Social Networking Presence: http://myspace.com/mayoclinic
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  • 22. Getting on YouTube: Feb. ’08
  • 23. Joining The Blog Council • Membership organization of blogging “companies” • Typically Fortune 500 members • Coca-Cola, P&G, Wells Fargo, etc. • Mayo Clinic, Kaiser Permanente, U.S. Navy among “non-traditional” members • Now the Social Media Business Council
  • 28. Sharing Mayo Clinic - Jan. 2009
  • 30. A Grammar Refresher on Verb Moods... • Indicatives - express a simple statement of fact • Imperatives - express a command or exhortation
  • 32. Millennials • Characterized by an increased use and familiarity with digital technology, social media and communication • With Median age of the world's population about 29, half were born in 1983 or later
  • 33. Millennials • 26 percent more likely than other adults to say “Social Networking is an important part of my everyday life” • 2010 research: students quitting social media showed same withdrawal symptoms as a drug addict who quit a stimulant
  • 34. Survey of college students born 1982–1992 • 97% owned a computer • 94% owned a cell phone • 56% owned an MP3 player • 76% used instant messaging • 92% of those reported multitasking while instant messaging • 40% got most of their news from TV • 34% got most of their news the Internet
  • 35. The Mass Media Malaise Indicative
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  • 38. The Octogenarian Idol Story • Alerted to interesting video of elderly couple playing piano in Gonda atrium • Video shot by another patient and uploaded to YouTube by her daughter • Video had been seen 1,005 times in six preceding months since upload • Embedded in Sharing Mayo Clinic, posted to Facebook, Tweeted on 4/7/09
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  • 45. May 4
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  • 53. May 26, 2009: Live in Studio Good Morning America
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  • 56. Results to Date • More than 8 million views on YouTube • >1.5 million views on Sharing Mayo Clinic • From 200 views/month to 5,000 views/hour • National TV coverage in U.S. and Japan
  • 57. #26: Your mileage may vary, but you’ll go a lot further if you get a car
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  • 66. Unique Myelofibrosis Patients MCF MCA 400 300 200 100 0 2008 2009 2010 2011
  • 67. Discovery by Richard Berger, M.D., Ph.D. Ulnotriquetral (UT) Ligament Split Tear
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  • 73. Nov 12, 2009 USA Today 3031031-7
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  • 75. Last Friday 3031031-9
  • 76. Less than 24 hours after my initial appointment, I not only had a new diagnosis - a UT split tear - but had surgery to correct the problem. As I write this, my right arm is in a festive green, but otherwise annoying cast. The short-term hassle, however, should be more than worth the long-term gain - the potential for a future without chronic wrist pain. A future, that without Twitter and those in the medical community willing to experiment with new communications tools, might not exist for me. 3031031-10
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  • 82. UT Split Repair Procedures 40 30 20 10 2007 2008 0 2009 2010 2011
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  • 91. Maybe Unfamiliar, Not Unfathomable
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  • 94. ©2011 MFMER | 3139261-
  • 99. Medical Education • Duty Hours: Reduce resident fatigue: 1984, NY, death of an 18 yr from potentially preventable drug interaction, when only 2 residents assigned to provide night coverage for night a busy hospital • An 80-hour limit to the work week was imposed on New York programs shortly thereafter.
  • 100. Medical Education • 80-hour weekly limit, averaged over 4 weeks • 10-hour rest period between duty periods and after in-house call • Maximum continuous duty period for G1s 16 hours • One day in 7 free from patient care and educational obligations, averaged over 4 weeks • In-house call no more than once every 3 nights
  • 101. Program Director Survey • Do you think the duty-hour regulations have an adverse impact on your ability to educate your residents? • 57% indicated it did
  • 102. Resident Surveys • Less time for formal educational activities/ conferences • Less time for informal education • Less time for ambulatory training • Loss of continuity of care (more handoffs) • Less time at bedside
  • 103. Medical Education • Fundamentally, social media tools serve two educational goals • Facilitate asynchronous geographically disparate encounters • Facilitates Social Constructivism: Learning where individuals engage around a task or problem
  • 104. Medical Education-Four Cs • Content-Rapid and transparent online access • Creation-Just as in health care, scalable leveraging occurs in learning as well • Connection-Networking, facile in practice begins in training • Collaboration-Participate where patients, providers, fellow learners and educators are
  • 105. Medical Education • Closed Facebook group for a medical resident clinic-fosters group expectations and notification • Tweeting national meetings: Leveraging education and networking opportunities
  • 106. Medical Education • Discussion Forums-SDN-40,000 active members, over 2 million unique visits and 12 million page views monthly • Wikis-Resident created and curated • Blog-Asynchronous education with social media feedback
  • 107. Medical Education • Fundamentally, our learners represent the first generation raised in an online era, mp3, iPad, iPhone and Twitter; and our educational recruitment, engagement and training must reflect this
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  • 111. SCAD? Findings being published in MAYO CLINIC PROCEEDINGS September 2011 issue ©2011 MFMER | 3139261-
  • 113. Information Overload • PubMed-21 million citations, one new/min • Over 200 Cardiology journals • 324 active diagnoses • Increasing online transparency and access • Does transactional clinical care pass the straight face test?
  • 114. Not just information overload…. Direct Care-20% Documentation-35% Assessment/ Vitals-7% Medication-17% Care Coordination-21% JONA, 39, 6:266-275
  • 115. Moral Imperative • Is it any wonder that 61% of us have sought knowledge and support online? • The value of that interaction is purely dependent on two factors: access to the conversation and the quality of the knowledge shared
  • 116. Moral Imperative • Yet, all too often, care providers are absent from the patient conversations • “Don’t want to be sued!” • “Who will pay for my time online?” • “What about HIPAA?”
  • 117. Moral Imperative • We are all the lived experts of our own disease • Media are evolving to the point that we all have access to the same shared knowledge • Providers can be partners with patients and walk with them on their journey online and offline • Providers can help shape the conversation, leverage information and ensure that credible content is available when patients need it
  • 118. Vaccine Hesitancy • Efficiency • Each discussion averages 5-10 mins • By 24 months, 14 vaccines in 8 visits • Liability • Several law suits brought by parents whose children suffered from vaccine refusal
  • 119. Vaccine Hesitancy • Risk • 13 years since Wakefield, dramatic drop in MMR vaccination in EU with a marked increase in measles and mumps • 2011-major measles outbreak in 33 EU countries, including 10,000 in France alone • US-80% of primary care providers report 1 vaccine refusal per month; 8% of providers report 1 in 10 parents refused vaccine
  • 120. Moral Imperative • Physicians must partner with patients in content creation, curation and decision making • Leverage the content, leverage the conversation, leverage the good
  • 121. Moral Imperative • Start small-begin with meaningful transactions • Good content made available to willing patients • Develop clear training (2010 only 10% of medical schools offered social media policies) and clear guidelines for engagement
  • 122. Moral Imperative • Advocate for those who may be excluded • Remember the access angels, libraries, houses of worship • Consider mobile capable information • Remember the disabled and chronically ill • Remember those with rare disease who geography isolates
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  • 131. Mayo Clinic CEO John Noseworthy, M.D.
  • 132. Mayo Clinic Center for Social Media • Our Raison d’etre: The Mayo Clinic Center for Social Media exists to improve health globally by accelerating effective application of social media tools throughout Mayo Clinic and spurring broader and deeper engagement in social media by hospitals, medical professionals and patients. • Our Mission: Lead the social media revolution in health care, contributing to health and well being for people everywhere.
  • 133. Social Media Health Network • Membership group associated with Mayo Clinic Center for Social Media • For organizations wanting to use social media to promote health, fight disease and improve health care • Dues based on organization revenues • Industry members eligible to join, but not accepting industry grant funding • >110 member organizations
  • 134. A Sample of Network Members • American Hospital Association • Radboud University Nijmegen Medical Center • Jamestown Hospital • National Cancer Institute • HCA • Vanderbilt University Medical Center • University of Michigan Medical Center • See Full List at http://socialmedia.mayoclinic.org/ network/
  • 135. For Further Interaction: • socialmediacenter@mayo.edu • http://socialmedia.mayoclinic.org • @LeeAase and @FarrisTimimi on Twitter • Keep tweeting at #HCSMNY