Social Media Yields Benefits, Poses Challenges for Healthcare Organizations

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By Kelly M. Pyrek

With social media no longer in its infancy, healthcare organizations are learning to embrace this dynamic way to reach the patients in the communities they serve. A recent study of 1,229 U.S. hospitals by Healthcare IT News found that 814 had Twitter accounts and 1,068 had Facebook pages.

However, healthcare facilities and practitioners in general have varying levels of engagement in social media, perhaps reflecting a slower adoption due to a number of influencing factors such as patient privacy issues and institutions' willingness to dedicate resources to this effort. According to a report from Computer Sciences Corporation (CSC), "Should Healthcare Organizations Use Social Media?" healthcare organizations have been slower to adopt social media than other business organizations, and although hospitals likely have higher adoption rates than other sectors of the healthcare economy, there is significant heterogeneity in use of social media. Large, urban, nonprofit/private, teaching hospitals and children's hospitals are the highest adopters.

For every hospital that promotes a hand hygiene flash mob video on YouTube, there's an organization struggling to make social media a priority among many competing demands. For many facilities, social media is aspirational, but for the Mayo Clinic, it's an instrumental part of daily operations.

The Health Care Social Media List, compiled by the Mayo Clinic Center for Social Media (MCCSM), shows about 1,500 healthcare facilities as actively using social networking sites and maintaining officially sponsored accounts on sites including YouTube, Facebook, Twitter and LinkedIn and including various blogs. The Center for Social Media is designed to accelerate effective application of social media tools throughout Mayo Clinic and spur broader and deeper engagement in social media by hospitals, medical professionals and patients. The MCCSM builds on Mayo Clinics leadership among healthcare providers in adopting social media tools, which began with podcasting in 2005. According to Mayo Clinic, it has the most popular medical provider channel on YouTube and more than 400,000 followers on Twitter, as well as an active Facebook page with more than 140,000 connections.

The MCCSM's social media philosophy states that the institution "believes individuals have the right and responsibility to advocate for their own health, and that it is our responsibility to help them use social media tools to get the best information, connect with providers and with each other, and inspire healthy choices. We intend to lead the healthcare community in applying these revolutionary tools to spread knowledge and encourage collaboration among providers, improving healthcare quality everywhere." Many of these precepts can be found in the book, "Bringing the Social Media Revolution to Health Care," which is MCCSM's textbook that explores strategic reasons to integrate social media into healthcare marketing and communications.

The MCCSM has even created an annual social media summit, part of the Social Media Week at Mayo Clinic. The impact of fourth annual event, held in late October, was discussed in the MCCSM blog by Farris Timimi, MD, a Mayo Clinic cardiologist and medical director of Mayo Clinic's Center for Social Media. In the blog, Timimi notes, "I am struck by the rapid progression and growing recognition of the value of social media as a means to address issues in healthcare. Ranging from clinical practice, medical education and research, striking examples were shared that show clearly how we have progressed from what had been viewed as a push medium marketing tool set to one that allows for engagement with our patients past and future, fundamentally where they are -- online."

In a recent YouTube video, Timimi observes, "We are seeing a change in the relationship between the patient and the healthcare provider." Noting that there is increased interest in a shared process of care and treatment, Timimi adds, "These [social media] tools help us reach so many more people; we can bring shared interactions into our practice and that is powerful ... This isn't an addition to your job. This is part of your job.  This is a conversation, and that is what we are trained to do ... This is where our patients are these days and this is where we need to reach them. We can engage learners, patients and peers, and we are not limited by geography or time. My goal is to educate and help people find ways to use these tools in their research, practice and education."

With social media being more than just a passing fad, healthcare organizations need to make key decisions about their participation in it. As the CSC report, "Should Healthcare Organizations Use Social Media?" emphasizes, "Social media is a radical change in the means of communication. Do not underestimate its ability to work for or against your organization." The report urges, "We believe healthcare organizations should be developing a social media strategy now. What is your organization going to do with social media now and what are your aspirational goals? What strategic business goals will you advance using social media? If you take a wait-and-see approach now you may soon find yourself trying to catch up with others in your market."

CSC's Global Institute for Emerging Healthcare Practices (CSC, 2011) has identified the following healthcare business goals that can be advanced by the use of social media:
- Marketing
- Workforce recruitment
- Brand management
- Reputation management
- Consumer relations
- Consumer/patient/health professional education
- Health professional collaboration
- Community creation
- Wellness
- Population and patient monitoring
- Care management
- Care coordination
- Clinical trial recruitment
- Surveillance, analysis, product development

Cyberspace is not without its hazards, however, as institutions fret over legal concerns related to patient privacy violations or other slip-ups that can be used against a facility. As the CSC report explains, "Organizations using social media face losing control of their message. Once a comment or tweet is posted, anyone can respond. While some users may share positive feedback, the door is also open to negative comments, which, however unfounded, can taint an organizations reputation. In addition, social media can expose organizations to privacy, security and ethics breaches, even if the organization does not have a formal social media presence. Clinicians and staff may inappropriately share confidential information about patients and the organization. Sharing protected health information violates HIPAA and can have serious ramifications for the individual as well as the organization. Social media also raises new ethical questions about patient/provider relationships. Both patients and providers navigate social media channels; interactions on these sites are blurring traditional boundaries. Some fear this could negatively impact patient care by impairing providers professional judgment. Some providers also fear that interactions with patients on social media sites could expose them to malpractice lawsuits if their comments are misinterpreted."

Healthcare organizations are encouraged to take reasonable precautions to mitigate risks. As the CSC report suggests, "Establishing policies to govern employees use of social media is a critical step that organizations must take to protect themselves ... Minimally, an effective social media policy should reiterate that employees must adhere to legal requirements, federal regulations, and corporate policies and procedures in their social media use and that patient privacy and confidentiality standards apply in all settings, including the Internet. Policies should clarify what information can and cannot be published on social media sites, and encourage individuals to keep the content of postings professional and respectful of colleagues and patients."

The CSC makes the following recommendations:
1. You cannot afford to take a wait-and-see approach. Although some believe social media is a passing fad, we believe it is here to stay and the sooner your organization develops an active presence, the less distance you will have to make up later.
2. You should have a social media policy, minimally, to protect against security, privacy or ethics breaches by your employees or customers. You should also offer staff education. Training and outreach are necessary to ensure that staff fully comprehend and are able to carry out the policy.
3. Use social media to go where your customers are. Listen to what others are saying about your organization, your product(s) and your brand(s). Monitor the social media activities of others in your market, and use social media to listen to what others are saying about your competition.
4. Consider starting where many organizations start: use social media to enhance marketing, branding, recruitment, reputation management and customer relations.
5. You do not have to develop a full-blown social media strategy now, but eventually you will need one. Start now but start small and monitor outcomes. Ask what your organization should be doing now to anticipate a more widespread use of social media to help accomplish key healthcare goals. Then expand your social media activities into new areas of value.
6. Recruit social media managers internally. Distribute responsibilities among staff who know your organization, are Internet-savvy and are excited about using social media to benefit your organization. Keep social media content accurate and current.

But what if a healthcare organization is unmoved by the potential benefits of social media and blocks use by its employees? Mayo Clinic's Timimi addressed the issue in an MCCSM blog entry following Mayo Clinic's 2012 social media summit: "I was struck by how many attendees, despite profound opportunities, represented organizations that still block social media access for their employees. Many institutions take a 'risk mitigation by elimination' approach. At many sessions, well over half the attendees indicated that their organization blocked some if not all social media sites for their employees. From our perspective they are choosing to take their most powerful asset, their human bandwidth, offline." Timimi continues, "To engage, we need to understand. We need to begin by asking and assessing who is blocking. Once we understand the extent, we can begin to measure the impact blocking has on employee satisfaction and retention. Beyond the impact on employee satisfaction, the majority of HCAHPS patient experience survey questions focus on basic communication skills. Sub-par HCAHPS scores bring penalties that have significant financial impact on hospitals, and interventions that improve performance provide obvious benefits, leading us to ask: 'How is engagement and conversation with patients impacted by social media blocking?' and 'Does unblocking improve HCAHPS performance?'"

To help understand the issues of blocking social media sites, the MCCSM is conducting a healthcare social media survey to assess the extent to which healthcare and health-related organizations are using social media tools and have developed policies or guidelines for employees use. Among the questions asked in Mayo survey is what are the main reasons for blocking access to social media sites, with the possible answers of network bandwidth, network security (exposure to viruses and malware), employee productivity, concerns about HIPAA violations or lapses in professionalism, and legal liability. 

References

Mayo Clinic Center for Social Media. http://www.youtube.com/watch?v=E0quTLzVBu0. Accessed Oct. 22, 2012.

Computer Sciences Corporation (CSC). Should Healthcare Organizations Use Social Media? 2011.