Social Media + Healthcare

Social media has become an undeniable force, and its rapid, informal communication style represents both possibility and liability for healthcare organizations. Good policies and training help organizations pursue the benefits and mitigate the risks.

By Cecilia Backman, MBA, RHIA, CPHQ; Susan Dolack, MHIM, RHIA; Denise Dunyak, MS, RHIA; Laurie Lutz, RHIA, CHPS; Anne Tegen, MHA, RHIA, HRM; Diana Warner, MS, RHIA, CHPS, FAHIMA; and LaVonne Wieland, RHIA, CHP

Social media refers broadly to Web-based tools that allow individuals to communicate quickly, easily, and broadly. Current popular social media sites include Twitter, Facebook, LinkedIn, and YouTube; in addition, millions of individuals publish their thoughts and interests through blogs. The days are gone when mass communication belonged to mainstream print, television, and radio companies.

Social media represents a brave new world for healthcare. It offers a venue for communicating with consumers quickly and inexpensively, such as promoting new wellness programs, marketing new services, and announcing the latest achievements in patient care. It also presents challenges, including risks to information accuracy, organizational reputation, and individual privacy.

Establishing appropriate staff use of social media through policies, position statements, and guidelines is an essential first step in mitigating the risks. Most importantly, organizations must educate staff and closely monitor the social media channels they sponsor.

Growing Use in Healthcare

Many healthcare organizations are using social media to engage with patients and consumers. One organization to embrace it wholeheartedly is the Mayo Clinic, whose Center for Social Media has a stated mission to "lead the social media revolution in healthcare, contributing to health and well being for people everywhere."
Mayo Clinic actively uses YouTube, Facebook, and blogs. It has more than 100,000 followers on Twitter, where on a typical day in February it published an announcement of a major philanthropic gift, a link to a video tour of its Florida facilities, and inspirational quotes. Its "Sharing Mayo Clinic" blog presents "stories from patients, families, friends, and Mayo Clinic staff."
The primary focus for most organizations' social media programs is marketing and communications. Social media is moving people away from a reliance on advertising in making purchasing decisions; consumers are relying more on the information they find online. For healthcare, this becomes increasingly relevant as the public has access to quality and cost ratings.
Consumers also are using the opinions they find online to inform their purchases. Companies are using social media to market their messages and encourage their customers to promote their products and services. Healthcare organizations that offer a venue for patients to share their positive experiences and personal stories can send a powerful message to consumers who are determining where to obtain their healthcare services.
Healthcare organizations also use social media to communicate their mission and vision, describe the services they offer, and provide health education. Some organizations use social media to promote wellness and sponsor online support forums where individuals who are dealing with chronic health issues or catastrophic conditions can find support from others who are having similar experiences. On some sites, physicians and other clinicians educate the public on common diseases, what can be done to cope with conditions, and how to maximize the quality of life for the individual who is suffering from the disease.
Many organizations use social media to encourage philanthropy. By publicizing their services, promoting patient advocacy, displaying credentials, and describing the tangible and intangible community benefits they provide, organizations can encourage benefactors to invest in their mission.
Finally, many organizations including healthcare are using social media for recruitment. They advertise their available positions and also search social media sites to determine the integrity and trustworthiness of potential hires. Human resources departments must be fully aware of labor laws when accessing social media on new hires or current employees.

Unintended Outcomes, Good and Bad

Perhaps the greatest fears organizations have about social media is the inability to control the conversation. People may say bad things about the facility—true or not—that can damage its reputation. At the same time, people may say very good things that can promote the facility. Learning to highlight the positives and manage the negatives is imperative for any organization embarking on social media.

Some risks are internal. Employees, medical staff, contractors, or volunteers who use social media may not grasp its ability to publish comments far and wide. One incorrect or flippant remark can become indelible, reaching audiences who lack the ability to read facial expressions or hear intonation. They may not be able to discern something said in jest from something said in earnest.

Improper descriptions or discussions of a patient case on social media could violate a patient's privacy, even if no names are used and no harm is intended.

Take for example a nurse who lives in a rural area and has a frustrating experience with a patient one day. Coming home she merely intends to blow off steam to friends by venting about the situation on her Facebook page. Although she does not divulge any protected health information, one of her Facebook friends recognizes the patient based on the description and the situation. The friend is related to the patient and shares the nurse's comments. The patient is angry with the organization and accuses it of negligence in protecting her health information.

Even acts of kindness can have complicated and unintended outcomes. For example, a staff member who communicates with a patient or family through an online support community could set up scenarios for boundary issues and claims of care disparity.

External risks are harder to manage. Social media opens up an organization to public criticism. However, as social media experts like to say, customers are already talking about companies online—by joining them, companies can help direct the conversation.

A patient who has a less-than-desirable experience or outcome during an encounter can convey his or her displeasure via social media—perhaps even on the facility's own social media site. When this happens, an organization that has fostered positive patient comments and has promoted its awards, accreditations, and community service will maintain better equilibrium when negative comments appear and retain more public confidence.

Finally, there are times when social media delivers unintended and unexpected outcomes that are wholly positive. In 2008 a woman and her mother leaving the Mayo Clinic stopped in the lobby to listen to an elderly couple playing the piano. The woman asked the couple to play another song and took a video of them with her phone. She posted the video to YouTube, where more than 7.5 million people have viewed it.

This simple video communicated an image of the Mayo Clinic that no amount of purposeful advertising could have yielded.