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Air Force Medical Service (AFMS)
Electronic Health Communication Strategy:
“Case Study to Improve Service and Health By Using
Social Media and Mobile Applications”
International Defence Sector Conference on Social
Media, Nov 2012
Col (ret) Douglas E. Anderson
quilldogdea@gmail.com
@doug_anderson57
C: 703-282-7669
O: 304-263-4405
Nov 2012

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Facebook Nut?
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Not This
Post This

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Purpose and Overview
 Purpose: Provide overview of AFMS Digital Health
Communication Strategy
 Overview:
 Social Media
 Strategy
 Facebook
 Twitter
 Web Site
 Mobile Apps
 Lessons
 Summary
 Questions
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http://www.youtube.com/user/AFMSCEMMTube?feature=results_main

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 Mission: Deliver world class health care to 2 million+ beneficiaries at 75
worldwide military treatment facilities (MTFs)—Trusted Care Anywhere
Background
 Guidance:
 Need a way to engage audience
to improve health outcomes
 Lacked digital media presence
 Execute digital health
communications strategy
 Social media, web site
standardization & mobile
health applications
 Context:
 Strategy Management
 Transformational Leadership

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Initiative: Social Media
 Challenge: Improving service and health through engagement
 Context: Communication, marketing, and outreach planning
 Leverage digital communication channels
 Objectives:
 Develop strategy and policy for AFMS-wide adoption
 Establish Facebook Pages @ 75 MTFs to begin journey
 Deliver guidance, training, and content to sustain effort
 Transformational Leader Approach:
 Conduct environmental scan
 Engage early adopters
 Listen to healthy skeptics
 Establish oversight team
 Promote success stories
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Social Media Strategy “Too EESI”
Objectives
 Enhance Health and
Experience of Care By
Increasing Activation
and Engagement
 Expand AFMS Social
Networking Presence
With Innovative Ideas
 Stabilize Effort with
New Tools, Training,
Guidance
 Integrate Other
Electronic Health
Initiatives Projects
(eHIP) for Effect
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Results: Facebook Fan Growth
 Achieved strong growth the first two quarters of 2012
 Q1 (Jan-Mar): Grew from 4,094 to 4,875 Fans or 19%
 Q2 (Apr-Jun): Grew from 4,875 to 5,355 Fans or 13.2%
 Context: Mayo Clinic = sustained growth rate of 11.2%
 Benefit: Due to multiple live engagement campaigns, viral content
sharing led to 3,284,239 impressions on AFMS content
 Observation: Improved health literacy--38% of all posted content
focused on information to improve service and health

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Results: Live Feedback Campaigns
Generated Visibility and Interest
 Began with “passive” discussion groups
 Health benefits of an Elevated Work Station
 Conducted 5 live Proactive feedback
campaigns to enhance follower engagement on
health topics and expand the AFMS presence
 Patient Safety Virtual Scavenger Hunt:
 Posted 8 patient safety clues on the Page
wall; invited fans to submit answers
 Results: 405 people Talking About This, 169
new Page “Likes” & viral reach of 5,000+
 Patient Centered Medical Home (PCMH) Forum:
 Hosted 1-hr forum with content/input from
4 MTFs, PCMH leadership and partners.
 Results: 861 Facebook Page views; 30 new
Facebook Fans; reach of 6,212

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Initiative: @USAFHealth Twitter
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Consistent
Visual
Branding
Cross
Promoted
Web
Properties
Description
Consistent
with Other
Military
Branches
Accounts
Public
Description
Cleared by
Public
Affairs
Social
Media
Policy Link
Social
Media
Policy Link
Popular,
Publicly
Recognized
Descriptor
for Account
Context

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Results: Twitter @USAFHealth
 Launched Twitter Jan 2012: 1,100+ tweets; gained 780+ Followers
 Live Chats #AFHealth have conversations around relevant
topics: Patient Safety, Wound Care, Men’s Health.
 Results: 952,548 impressions; grew from 214 followers on
March 1 to 660 followers on July 1 – a 208% increase
 Benefit: @USAFHealth developed ongoing dialogue and continued
to nurture relationships with other health organizations across
social media outlets, sustaining a 74.3% growth rate during Q2

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Results: Training and Support
 Training resulted in 1,800+ personnel training:
 Conducted 101 and Introductory Facebook training sessions
 Integrated into executive leadership education
 Developed and delivered specialized training:
 Customer Service, Patient Safety, Health Promotion
 Disaster and Crisis Response & Global Health Engagement
 Applications for Personal & Professional Development
 Support provided learning forum share best practices and ideas:
 Hosted Social Media Working Groups to transfer materials
 Developed “How To ” toolkit for knowledge transfer

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Results: Utilization is
Increasing
 Observation: Improved health literacy--38% of all posted and
viewed content focused on improving service and health
 Notable MTF-level examples include:
 Record number of people receive flu shots as a result
 Ability to communicate during the 2011 earthquake in Japan
 Health and Wellness marketing and Diabetes support groups
 Saving time by responding to Fans questions via Facebook
 Engaging patients on health tips an patient safety
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Results: Leadership and Professional
Community Interest Grew
 Developed virtual neighborhoods to acquire, share, and use of
relevant info supports personal & professional development:
 Global Health Engagement (International Health Specialist)
 Health and Wellness Centers
 Dental, Medical, Nursing, and Medical Service Corps
 Occupational and Physical Therapy
 Senior Leadership engagement
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AFMS Quad Aim:
Top Monthly Posts & Viral Reach
Month Post Likes Feedback Shares Total Reach
June
Men’s Health
Month
“It's official!!
Congratulations to our
21st Air Force Surgeon
General, Lt. Gen. (s)
Thomas W. Travis! The
Senate has just confirmed
the assignment!”
82 Talking about this: 82
Engaged users: 85
Total Impressions:
3241
6 1471
Facebook This Month (Change)
Fans 5,206 (199)
▲
Wall Posts 47 (16)
▼
Likes 366 (62) ▼
Comments 28 (21) ▼
Shares 89 (48) ▼
Post Views 29,601 ▼
AFMS MTF Pages:
“Basic”
“Advanced “
“Awesome”
49/65 ▲
6/65 --
6/65 --
Air Force Medical Service Social Media Dashboard: June 2012
Benchmark: Competitive Engagement
Spotlight: Men’s Health #AFHealthChat
Other Outreach
Channels
This
Month
AFMS Public Website:
• Total Visits 40,677▼
CAG Kx downloads June:
• Top 3 Docs
• AFMS Web
Standardization Basic
Toolkit
• AFMS Quad Aim READY
• AFMS Web
Standardization Kickoff
Deck
54
41
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Twitter:
• Followers 680
Better Health:
Ready:
.
Best Value:
Better Care:
The event resulted in:
• 855,249 impressions
immediately after the chat
• 131 Men’s Health tweets
(69 from AFMS, 62 from
participants
• 80 new followers (6/13-
6/29)
Better Health:
Yokota AFB led a fun run for Men’s
Health and Offutt AFB celebrated
Running Day, announcing their
HAWC’s weekly run. Minot AFB
shared resources for safety during
rising temperatures.
Ready:
With summer being a popular PCS
and deployment time, Los Angeles
AFB shared information about the
new Military “Health in Transition”
program to assist in easing the PCS
transition.
Best Value:
Scott Clinic’s Patient Advocate
followed up with a fan after
assisting them offline. The fan later
remarked on their wall how speedy
and effective the Patient Advocate
always is for helping with issues.
Better Care:
Eglin AFB used their Page to
publicize that their Satellite
Pharmacy is extending its hours for
people who work later shifts. Tyndall
AFB shared a calendar of prevention
activities to support Mental Health.

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Initiative: Web Site Standardization
@ 75 MTFs Began Jun 2012
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 Best Practices
 Checklist Based on Levels
 Basic/Advanced/Awesome
 Sample Text & Images
 Standardized template
 Mock-up example template
 Score Card

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Results and Status: Web Site
Standardization
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 Approach:
 Conducted environmental scan; assessed MTF web pages
 Hosted focus groups: content developers, audience, PAOs
 Identified pilot sites to pin-point advanced social media users
and enthusiasts; program helped identify information gaps
 Launched system-wide “Get to Basic” Campaign
 Status as of Jul 2012:
 54 MTFs or 73% made progress on getting to Basic
 Average number of Basic elements across all MTFs: 10/15
 19 MTFs have reached Basic level; 22 have 10+ elements

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 As patients and providers became more
interested, the AFMS recognized the need
to develop mobile applications strategy
 Conducted analysis including research
from focus groups & social media surveys
 Produced 3-tier development strategy
 Designed to manage use, development,
and promotion
 Tier 1:
 2 Prototypes: MTF Locator & Diabetes
 User adoption and outreach strategies
to help maximize use of apps
 Trusted Mobile Library with
instructions
Initiative: Mobile Health Applications

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Trusted Source for Mobile Health
Applications To Start
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Mobile apps to better manage your health on the go. Search
The Air Force Medical Service recommends the following mobile health applications for use by Medical Group providers,
beneficiaries and their families. Read more about each app below, organized by category and audience, including
download links for Apple and Android operating systems.
Mobile Apps by Category:
Get Fit & Healthy Manage Your Family’s Health Locate a Health Facility
Find Benefits Information For Health Care Providers
Mobile Apps by Thumbnail:
External Link Disclaimer
The list of external links above does not
constitute endorsement by the United States
Air Force, or the Department of Defense, of
the external Web sites, mobile applications,
or the information, products or services
contained therein
Get Healthy & Fit Manage Your Family’s Heath Mobile Web Resources
PTSD Coach was designed for Veterans and military
Service Members who have, or may have, Posttraumatic
Stress Disorder (PTSD).
Apple Android
Tactical Breather can be used to gain control over
physiological and psychological responses to stress, which
can dramatically benefit soldiers during stressful combat
situations.
Apple Android
The National Heart, Lung and Blood Institute’s Body Mass
Index Calculator is a tool to screen for weight categories
that may lead to health problems.
Apple Android
Passport to Good Health helps users organize and keep
track of their health records, preventative screenings, test
results, medications, health care professionals and
upcoming appointments.
Apple Android
My Health Records helps users store and access health
care information for all family members.
Apple Android
EatingWelll Healthy in a Hurry is a selection of 200 of
EatingWell’s most popular and fastest-to-make recipes. The
app features preloaded recipes with full nutritional
information and professional photography accompanying
each recipe.
Apple Android
TRICARE Online
TRICARE Online provides secure access to online
features for DoD beneficiaries receiving care
through a military treatment facility.
Visit: https://www.tricareonline.com
WebMD
WebMD provides valuable health information, tools
for managing your health, and support to those
who seek health care information.
Visit: http://www.m.webmd.com/

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Content Calendar Helps
Manage Messaging
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Quality and Patient Safety Communication
Campaign Plan, Strategy, Toolkit
 Quality & Patient Safety Campaign ties
MHS Quadruple Aim and AFMS translation
for Better Care/Best Value
 5 messages focus on trust & quality of
care involving patients as part of the care
giving team
 Safe Culture … Safe Care … Safe
Patients … Safe Staff … Safe Support
Systems … Safe Place ….
 Designed to be ongoing and proactive
 For Internal and external audiences
 60+ tools, templates, and ready to use
materials available on AFMS Kx (CAG)

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 Suicide Prevention Campaign ties into MHS
Quadruple Aim and AFMS’ goal for Better Health
 Four key messages focus on providing Airmen,
civilians, and family members with information to
prevent suicide and save lives
 Plan designed to be adaptable at local level
 Campaign period designed to enduring
 More than 50 tools, templates and ready to use
materials available on the AFMS Knowledge
Exchange (Kx)
 Materials acquired from:
 MHS, VA, Military Pathways
 DCoE, Real Warriors Campaign, AHRQ
Suicide Prevention Communication
Campaign Plan and Toolkit Highlights
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Suicide Prevention Toolkit
Example Campaign Plan
Commander Upbriefs - Key Messages
Press Release and Campaign Engagement E-mails
SP Resource List with Links
Newspaper Articles and Talking Points,
Poster, Flyers, AFMS SP Comm Card, ACE Card
Social Media Tools: Facebook posts, Tweets, Blogs
FAQs, Brochures, Fact Sheets, Other Materials
PSA, SME Interviews, Impact Stories

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Helping MTFs Combine Local Initiatives With
Communication Campaign Plans to Maximize
Their Efforts to Activate Audiences
 MTFs can use “mini communication campaign” Plans as part of PCMH
implementation OR continue patient activation and engagement with
their beneficiaries after implementation. Current examples include:
 Diabetes
 Childhood Vaccination
 Fitness
 Materials in these plans and toolkits include:
 Communication messages, sample campaign implementation plan,
toolkit contents
 Email announcements
 Resource lists, flyers, posters
 E-cards from health.mil
 Childhood vaccination
 Social media language
 Outcome: Improved health, better HEDIS rates, staff satisfaction?
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Myths vs Facts: More Positives Than
Negatives … Fans Take Care of Fans
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1 Fan, 1 Response, Many Views
Toolkit Provides Sample Responses

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Partnering and “LIKING” Other Interested Organizations
Such As Spouses Groups Improves Messaging “Reach”

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Social Network Support Groups
Critical to Patient Activation
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 Have a Purpose: Align to larger AF electronic health initiatives and
strategic communication plans: inform, engage and inspire
 Do Your Homework: Each facet of the strategy included baseline
research to identify gaps, needs, and concerns – listening works
 Build on What’s Working: Instead of mandating changes, sharing
information and empowering MTFs helped the AFMS achieve its
goals--Working with partners greatly increased viral reach
 Connect the Dots: While adjustments were made, ensure pieces of
the strategy link together--drives the audience to all channels
 Experiment: Develop, test, and evaluate new engagement tactics
to keep the audience engaged and active—fail forward
 Be Proactive: Learn, research, ask, listen, collaborate, cajole …
enjoy the journey – do it, try it, improve it
Proactive Leadership Required For a
Successful Digital Health Strategy
http://www.youtube.com/watch?v=fW8amMCVAJQ

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Summary and
Conclusion
 Successfully implemented a digital health
communication strategy & implementation plan
 Reached diverse and dispersed audiences
 Award winning initiative is easily replicated
 Well-organized toolkit with 400+ documents
 Application of transformational and change
management strategies required for initial and
sustained success
 Local innovation with proper guidance, tools,
and training will improve activation
 Satisfaction with services will improve
 Engaging patients to play a role in their health care
contributes to health literacy and better health
 Special thanks to the Team
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Questions? All Materials Available
Upon Request
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Col (ret) Douglas E. Anderson is the former Director of the US Air Force
Surgeon General’s Commander's Action Group (Health Communication,
Marketing, and Organizational Improvement). In this capacity, he and his teams
developed strategic health communication, marketing, and thought leadership
programs for the Air Force Surgeon General and Air Force Medical Service
(AFMS). He implemented innovative strategies and tactics to deliver messages
across the enterprise in a wide range of communication channels. His team
developed, implemented, and managed digital communication, social media, and
events planning programs. In addition, he provided in house group facilitation
services on strategy creation, quality improvement, and performance measure
development. He personally coached senior executives on strategic thinking,
health trends assessment, social media presence, speech development, public
speaking, and conference planning.
Email Contact: quilldogdea@gmail.com
Cell Phone: 703-282-7669
Home Phone: 304-263-4405
Disclaimer: The presentation was provided for educational purposes only. It does
not represent the official position of the US Air Force. It is based on Col
Anderson’s experience while serving in the military, current consultation services,
and personal experience. It should not be construed as official endorsement by the
US Air Force.

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