This document summarizes key findings from a study analyzing over 1,300 US physician Twitter accounts and 400,000 tweets. Some high-level findings include:
- Physicians use Twitter for various reasons like connecting with patients, learning, and gathering feedback.
- Analysis found accounts reflected physician specialties and geographic distributions. Most profiles identified as physicians and linked to websites.
- Tweeting peaks during work hours and evening, with topics often relating to specialties like breast cancer, diabetes, and prostate screening debates.
- The study provides more in-depth analytics on topics discussed, connections between physicians, and how Twitter may fit into physician workflows. Automated tools enabled a broader analysis than previous studies.
3. But why are they here?
• Discover Needed
Services
• Improve Customer
Service
• Gather feedback on
medications
• Compare and improve
quality
3
http://www.ama-assn.org/amednews/2012/06/25/bisa0625.htm
Contents are proprietary and confidential.
#AMAAHC | @chimoose
4. With over 18,000 followers from medical communities, with
the right strategy and communication, I can leverage the real
power of my networks by using crowdsourcing very difficult
questions and issues. Twitter is the fastest and most
interactive social media channels in my work.”
Dr. Bertalan Mesko
twitter.com/berci
linkedin.com/in/bertalanmesko
Scienceroll.com
Contents are proprietary and confidential.
4 #AMAAHC | @chimoose
5. Connection promotes health, and twitter proves the model
that simple digital tools can vastly increase connection.
Aaron Stupple
Resident, Beth Israel Deaconness
Medical Center
twitter.com/astupple
http://adjacentpossiblemed.blogspot.com/
Contents are proprietary and confidential.
5 #AMAAHC | @chimoose
6. I think using Twitter and other social media outlets has
benefited me by letting me know where the patients are. I
learn from their stories and I have a chance to truly hear
them. In addition, I find social media beneficial as a learning
source to interact with other physicians and med students I
never would have met if I were confined by the walls of my
own hospital.
Danielle Jones,
Medical Student
twitter.com/daniellenjones
Mindonmed.com
Contents are proprietary and confidential.
6 #AMAAHC | @chimoose
7. A benchmark
In 2010, Dr. Katherine
Chretien of the VA Medical
Center in Washington led a
team in producing the first
known scholarly study of
physicians’ use of twitter
7
[ New, automated tools have enabled
us to broaden the scope of our study
Contents are proprietary and confidential.
#AMAAHC | @chimoose
[
8. Standing
on the
shoulders …
The Chretien Study
260 5,156 Data Collected and
tweets Analyzed between May 1st
US Physicians and May 31st, 2010.
from 260 physicans – the most
recent 20 from each
The power of automation
Study
1,397 403,553 Data Collected and Analyzed
US Physicians tweets between October 3 and
validated against CMS’ National generated between October 15, 2012
Provider Identifier database May 1, 2012 and September 30, 2012
8 Contents are proprietary and confidential. #AMAAHC | @chimoose
9. Study Demographics
9 Contents are proprietary and confidential. #AMAAHC | @chimoose
10. Reflecting the Population Plastic
Surgery
3%
… indexed within
1,397 +/- 3 %
of the total count
US Physicians*
99.5 %
Of Specialties…
Residents
-6 %
10 Contents are proprietary and confidential. #AMAAHC | @chimoose
11. Reflecting geographic distribution
49 states
indexed within +/- 4%
of the total count
overindexes
underindexes
11 Contents are proprietary and confidential. #AMAAHC | @chimoose
12. Reflecting gender distribution
Overindex
on twitter
by
8%
Underindex
on twitter
by
8%
12 Contents are proprietary and confidential. #AMAAHC | @chimoose
13. Physician Profiles
78 %
identify
themselves
clearly as
such in their
twitter bio
32 %
link to a personal blog
or website
80 %
contain a
URL in their
bio
13 Contents are proprietary and confidential. #AMAAHC | @chimoose
14. How are MDs using their accounts?
Bio URL Distribution
6.90%
1.90%
93 %
of all Plastic Surgery
37.70%
URLs are links to their
practice
31.90%
Business Medical Resource Personal Blog/Website Practice
14 Contents are proprietary and confidential. #AMAAHC | @chimoose
15. Twitter Activity – Time and Frequency
15 Contents are proprietary and confidential. #AMAAHC | @chimoose
17. Tweets per day over
Account Lifetime
Pediatrics
Ophthalmology
Radiology
Otolaryngology
Emergency
Medicine
All MD Average
17 Contents are proprietary and confidential. #AMAAHC | @chimoose
18. Tweets per day over
5 months
May’12 Jun’12 Jul’12 Aug’12 Sep’12
42
are
%
increasing
frequency
34
are
%
tweet at least 1 time
per day
9 % maintaining
frequency
50
are
%
decreasing in
frequency
18 Contents are proprietary and confidential. #AMAAHC | @chimoose
19. When can I find MDs on Twitter?
Eastern time
Morning Workday Work PM Evening Overnight
(0500 – 0800) (0801 - 1200) (1201 - 1800) (1801-2300) (2301-0459)
18 % 22 % 32 % 12 % 17 %
32%
22%
18% 17%
12%
Morning (0500 - 0800 Workday (0801 - 1200) Work PM (1201 - 1800) Evening (1801-2300) Overnight (2301-0459)
0500-0800 0801-1200 1201-1800 1801-2300 2301-0459
19 Contents are proprietary and confidential. #AMAAHC | @chimoose
20. Twitter and the MD Workflow
Localized time
Morning Workday Work PM Evening Overnight
(0500 – 0800) (0801 - 1200) (1201 - 1800) (1801-2300) (2301-0459)
18 % 21 % 31 % 8% 22 %
31%
21% 22%
18%
8%
0500-0800 0801-1200 1201-1800 1801-2300 2301-0459
20 Contents are proprietary and confidential. #AMAAHC | @chimoose
22. MDs Most likely to be followed by peers*
25%
53%
Personal Blog/Website
27% Business/ Organization
All_Doctors
No Bio URL
practice
34%
40%
*Percentages measure MDs followed by at least 20 others in the data set
22 Contents are proprietary and confidential. #AMAAHC | @chimoose
23. How connected are online physicians?
%
34 of all MDs are followed
by at least 20 MDs
Pediatrics
Specialties who Emergency
are followed by Medicine
other MDs
Family
Medicine
23 Contents are proprietary and confidential. #AMAAHC | @chimoose
24. Topics
24 Contents are proprietary and confidential. #AMAAHC | @chimoose
25. Mining the Data
A sample
• Breast Cancer: (breast AND (cancer OR carcinoma)) OR (inflammatory AND
breast) OR (inflammation AND breast) OR (breast AND (metastasis OR metastic))
OR (duct AND (carcinoma OR cancer)) OR (lobe AND (carcinoma OR cancer))
OR "DCIS" OR "LCIS" OR (estrogen AND receptor AND positive) OR "HER2" OR
(breast AND MRI) OR (breast AND biopsy) OR (breast AND ultrasound) OR
"mammogram" OR "mammography" OR "tamoxifen" OR (aromatase AND
inhibitor) OR "exemestane" OR "trastuzumab" OR "Herceptin" OR "lumpectomy"
OR "mastectomy" OR "komen" OR "BRCA1" OR "BRCA2”
• Diabetes: "Diabetes" OR "Mellitus" OR "Insipidus" OR "Diabetic" OR "Gestational"
OR "blood glucose" OR "Blood Sugar" OR "NIDDM" OR "IDDM" OR "LADA" OR
("Antiduretic Hormone" OR "ADH") OR ("Arginine Vasopressin" OR "AVP") OR
"oral glucose tolerance" OR "fasting plasma glucose" OR "glycated hemoglobin
OR HbA1c OR A1c" OR "insulin" OR "SMBG" OR "hyperglycemia OR
hyperglycemic" OR "biguanides" OR "Sulfonylureas" OR "Meglitinides" OR
"thiazolidinediones" OR "alpha glucosidase inhibitor" OR "GLP-1 agonist" OR
"DPP-IV inhibitors" OR "DKA" OR "HHS"
Contents are proprietary and confidential.
25 #AMAAHC | @chimoose
26. Diabetes & Breast Cancer – Sample Search
Contents are proprietary and confidential.
26 #AMAAHC | @chimoose
27. The PSA Controversy
36
117
Doctors who state an opinion are
more than 3:1
against the USPSTF’s
ruling on PSA Tests
182
Negative Neutral Positive
27 Contents are proprietary and confidential. #AMAAHC | @chimoose
32. Appendix – Classification Count
Row Labels Count of classification
Internal Medicine 314
Family Medicine 168
Pediatrics 116
Psychiatry & Neurology 100
Student in an Organized Health Care Education/Training
Program 83
Obstetrics & Gynecology 76
Surgery 74
Orthopaedic Surgery 74
Dermatology 55
Emergency Medicine 53
Plastic Surgery 46
Otolaryngology 42
Anesthesiology 28
Radiology 27
Opthalmology 26
Urology 24
Allergy & Immunology 16
Pathology 14
Neurological Surgery 10
Preventive Medicine 10
#AMAAHC | @chimoose
33. Appendix – Classification Count
Thoracic Surgery (Cardiothoracic Vascular Surgery) 9
Physical Medicine & Rehabilitation 9
General Practice 8
Pain Medicine 4
Colon & Rectal Surgery 3
Hospitalist 2
Nuclear Medicine 2
Neuromusculoskeletal Medicine & OMM 2
Medical Genetics 1
Phlebology 1
(blank)
Grand Total 1397
#AMAAHC | @chimoose
34. Appendix – Specialty count
Allergy & Immunology 16
Allergy 7
Allergy & Immunology 8
Clinical & Laboratory Immunology 1
Anesthesiology 28
Anesthesiology 21
Pain Medicine 6
Pediatric Anesthesiology 1
Colon & Rectal Surgery 3
Colon & Rectal Surgery 3
Dermatology 55
Clinical & Laboratory Dermatological Immunology 1
Dermatology 36
Dermatopathology 2
MOHS-Micrographic Surgery 5
Procedural Dermatology 11
Emergency Medicine 53
Emergency Medical Services 2
Emergency Medicine 51
Family Medicine 168
Addiction Medicine 3
Adolescent Medicine 1
Adult Medicine 5
Family Medicine 151
Geriatric Medicine 2
Sports Medicine 6
General Practice 8
General Practice 8
Hospitalist 2
Hospitalist 2
#AMAAHC | @chimoose
35. Appendix – Specialty Count
Internal Medicine 314
Adolescent Medicine 1
Allergy & Immunology 2
Bariatric Medicine 1
Cardiovascular Disease 39
Clinical Cardiac Electrophysiology 5
Critical Care Medicine 2
Endocrinology, Diabetes & Metabolism 10
Gastroenterology 18
Geriatric Medicine 19
Hematology 2
Hematology & Oncology 17
Hospice and Palliative Medicine 5
Hospice Care & Palliative Medicine 2
Hospitalist 1
Infectious Disease 9
Internal Medicine 135
Interventional Cardiology 7
Medical Oncology 9
Nephrology 14
Nuclear Cardiology 1
Nutrition 1
Pulminary disease 1
Pulmonary Disease 3
Rheumatology 7
Sleep Medicine 3
Medical Genetics 1
Clinical Genetics (M.D.) 1
Neurological Surgery 10
Neurological Surgery 10
#AMAAHC | @chimoose
36. Appendix – Specialty Count
Neuromusculoskeletal Medicine & OMM 2
Neuromusculoskeletal Medicine & OMM 2
Nuclear Medicine 2
Nuclear Cardiology 1
Nuclear Medicine 1
Obstetrics & Gynecology 76
Gynecologic Oncology 5
Gynecology 6
Maternal & Fetal Medicine 2
Obstetrics 1
Obstetrics & Gynecology 57
Reproductive Endocrinology 5
Opthalmology 26
Opthalmology 26
Orthopaedic Surgery 74
Foot and Ankle Surgery 5
Hand Surgery 6
Orthopaedic Surgery 48
Orthopaedic Surgery of the Spine 5
Orthopaedic Trauma 2
Orthopedic Surgery 1
Sports Medicine 7
Otolaryngology 42
Facial Plastic Surgery 9
Otolaryngology 23
Otolaryngology/Facial Plastic Surgery 6
Pediatric Otolaryngology 2
Plastic Surgery within the Head & Neck 1
Sleep Medicine 1
#AMAAHC | @chimoose
37. Appendix – Specialty count
Pain Medicine 4
Interventional Pain Medicine 3
Pain Medicine 1
Pathology 14
Anatomic Pathology & Clinical Pathology 13
Blood Banking & Transfusion Medicine 1
Pediatrics 116
Adolescent Medicine 4
Developmental Behavioral Pediatrics 1
Neonatal-Perinatal Medicine 1
Pediatric Allergy/Immunology 3
Pediatric Cardiology 3
Pediatric Critical Care Medicine 1
Pediatric Emergency Medicine 2
Pediatric Endocrinology 4
Pediatric Gastroenterology 2
Pediatric Hematology-Oncology 3
Pediatric Infectious Diseases 3
Pediatrics 89
Phlebology 1
Phlebology 1
Physical Medicine & Rehabilitation 9
Pain Medicine 4
Physical Medicine & Rehabilitation 5
Plastic Surgery 46
Plastic Surgery 42
Plastic Surgery Within the Head and Neck 2
Surgery of the Hand 2
#AMAAHC | @chimoose
38. Appendix – Specialty Count
Preventive Medicine 10
Occupational Medicine 2
Preventive Medicine/Occupational Environmental Medicine 3
Public Health & General Preventive Medicine 5
Psychiatry & Neurology 100
Addiction Psychiatry 1
Child & Adolescent Psychiatry 10
Clinical Neurophysiology 3
Forensic Psychiatry 2
Geriatric Psychiatry 1
Neurodevelopmental Disabilities 1
Neurology 25
Psychiatry 56
Psychosomatic Medicine 1
Radiology 27
Body Imaging 1
Diagnostic Radiology 17
Diagnostic Ultrasound 1
Radiation Oncology 6
Vascular & Interventional Radiology 2
Student in an Organized Health Care Education/Training Program 83
Resident 83
#AMAAHC | @chimoose
39. Appendix – Specialty Count
Surgery 74
Pediatric Surgery 7
Plastic and Reconstructive Surgery 22
Surgery 32
Surgery of the Hand 1
Surgical Critical Care 2
Surgical Oncology 4
Trauma Surgery 4
Vascular Surgery 2
Thoracic Surgery (Cardiothoracic Vascular Surgery) 9
Cardiothoracic Vascular Surgery 8
Surgery 1
Urology 24
Urology 24
(blank)
(blank)
Grand Total 1397
#AMAAHC | @chimoose
Notes de l'éditeur
Discover needed servicesThrough social media, physicians can gain insight into what patients are willing to do to improve their health and what obstacles stand in their way, Kevin Abramson said in the PwC report. He is director of marketing planning for OptumHealth, a health management solutions company that is a subsidiary of UnitedHealth Group.Chris Keating, a physical therapist who manages social media activities for Strive Physical Therapy and Sports Rehabilitation in New Jersey, said Strive’s social media activities give him an outlet to find out what services and events interest people. When he posts photos of an event Strive held in the community, he’ll ask Facebook followers what events, such as screenings for certain medical conditions, they would like to see. It’s a way to get the information you want in a conversational way, he said.61% of patients say they trust information posted by physicians on social media.Jessica Logan, social media and online content specialist for the University of California, San Diego Health Sciences marketing and communications department, said she sees a lot of trends developing on Twitter that could indicate a need in the community. For example, she said she has seen a lot of discussion on ulcerative colitis. From a social media content perspective, she knows the community could benefit from her posting more information about that topic. From a business perspective, the conversations could help guide product or service development efforts.Although a small physician practice might not have the manpower to manage social media efforts, they are at an advantage when it comes to acting on information due to the smaller number of people making decisions. While it would be difficult for a large institution like UC San Diego to institute a program or specialized service immediately, a small practice has that flexibility.Jason Hwang, MD, an internist and executive director of health care at the Innosight Institute, a San Francisco-based research organization focusing on education and health care, said social media could provide a new way of tracking population health. Tracking health trends is becoming increasingly popular, as many practices move toward medical home and shared savings models. It also could identify “hot spots” for disease outbreaks.“A hospital or health system could engage social media to see what their patients are talking about and subsequently target those hot spots with certain therapies or interventions,” he said.Improve customer serviceHow a physician practice or hospital responds to negative comments and complaints can carry equal or more weight than positive consumer engagement, according to the PwC report. Unlike customer service issues brought to a practice’s attention in a survey, complaints made on social media can be addressed — and often remedied — immediately, because there is an outlet for a dialogue.Even though specific details should be kept offline, practices can respond in public with an apology and offer to correct the situation so that others can see action being taken. Logan said when other social media users see that a problem is being handled right away, they come to realize that customer service is taken seriously. It also gives the practice a chance to know about situations immediately so they are remedied and not exacerbated by an upset patient.Gather feedback on medicationsJared Rhoads, senior research analyst with CSC’s Global Institute for Emerging Healthcare Practices, said feedback on therapies is one of the most valuable uses for social media — and possibly one of the easiest to facilitate.“If 10,000 people start talking about a side effect of a drug, it won’t be that hard to find that out,” he said.Trends on Twitter sometimes indicate medical needs in the community.Monitoring Twitter buzz surrounding a certain drug, for example, would offer great insight into how patients are reacting to it. Not only is information on side effects useful, but information on therapies that are working well is valuable to physicians, he said. There may be insight about a therapy the physician hasn’t tried, or an alternative therapy he learns about through patient interactions on social media.Patient communities are a great source of information for physicians. HealthUnlocked in the United Kingdom, for example, has more than 100 disease-specific communities where patients share experiences and advice. With the users’ consent, the data are collected from their discussions and shared with physicians, researchers and pharmaceutical companies. (See correction)In the United States, companies such as Reading, Mass.-based InfoMedics use online communities to collect discrete data about topics patients might not always share with their physicians. They enter the online communities, and through questionnaires or surveys, ask questions that can be answered by patients in a quantifiable way.Gene Guselli, CEO of InfoMedics, said patients are often more comfortable talking about their health with a third party, even if they know their physicians is listening.Compare and improve quality
Chretian focused on professionalism while we’re looking more at behavior.
The male/female breakdown in the full MD population in the US is 65.% male and 34.2% female. In our dataset it is 73.7% male and 26.4% female. The actual variance represented in the data is 7.9%
32% MDs link to a personal blog or website, 38% link to a practice website, 9% link to a business and 2% link to a medical resource.
After plastic surgeons, orthopedic surgeons were the second highest of any % at 78.5% of practice links, followed by Dermatology at 77% of practice links. The specialty with the highest % of personal blog/website links is pathology at 66.7%. The specialty with the highest % of business links was is Anesthesiology at 22.7%. The specialty with the highest % of Medical Resource links is also Pathology at 22.2%.
The all MD average (found by doing analysis on the individual level is 2.3x/day. The numbers per specialty are Pediatrics: 3.9/day, Opthalmology: 3.2/day, Radiology: 3.1/day, Otolaryngology: 3.0/day and Emergency Medicine: 2.7/day.
(Calculated at individual level) Median tweets/day is .5. 22% tweet between 1.5 and 2.5 times/day.
Percentages represent the percent of MDs within that category that have at least 20 MDs from database following them.What are the implications for different uses of twitter? Engagement vs. Filtering vs. Newsgathering vs. Spamming
% of MDs followed by at least 20 other MDs by specialty: Pain Medicine 50%, Family Medicine 49%, Pediatrics 45%508 of 1397 36% were mentioned at least once by another physician in the data set
Top Linksnpr.org16medpagetoday.com15latimes.com9alvinblin.blogspot.com7annals.org7jwatch.org7medscape.com7usatoday.com7wsj.com7penispowerbook.com6aafp.org5ascopost.com5youtube.com5
This slide should be available in print out version but not in presentation.These are the classifications with more than 10 doctors.
This slide should be available in print out version but not in presentation. These are classifications with fewer than 10 doctors.
Should be available in printout version but not in presentation.
Should be available in printout version but not in presentation.
Should be available in printout version but not in presentation.
Should be available in printout version but not in presentation.
Should be available in printout version but not in presentation.