Social Media & Mobile Health The Good, the Bad, and the Ugly Learning Objectives Gain knowledge of legitimate and innovative uses of social media and mobile technologies that contribute to improved patient outcomes and experience Recognize the threats and develop strategies to manage the risks and minimize loss 2
Christina Thielst, FACHE Vice President, TOWER 30+ years hospital administration & consulting Blogging since 2005 Christina s Considerations Author Social Media in Healthcare, Exploring New Media (self-study course), Health IT Online Seminar and many articles/papers MHA from Tulane University, SPHTM Member: ACHE, HCESoCal, HIMSS, ATA 3 Agenda Social media defined Good, bad and ugly examples Drivers and trends Business and operational issues Managing risks Channel specific advice 4
Great Tweet! @msbluebells I feel the same way about hospital gowns as I do using social media... I am never sure what I might be showing... :) 3:02 PM - 16 Feb 12 via web Embed this Tweet 5 Social Media Defined Electronic tools that enhance communication, support collaboration & enable users to generate and share content At least bi-directional Dialogue and collaboration in building content Easily accessible anywhere, anytime -- on a mobile device, laptop or desktop computer Immediate right now 6
The Ugly Four employees fired/three disciplined for posting pictures of dying patient on FB (St. Mary s Medical Center, Aug 2010) Doctor disciplined for revealing patient info on FB (Westerly Hospital, Apr 2011) Medical students posting comical maladies with captions on body parts Agency Employee makes fun of patient on FB (Providence Holy Cross, Jan 2012) Family raises ethical concerns on FB (Jan 2011) Mutual Agreement to Maintain Privacy Malware & viruses can spread through social media 7 Privacy & Confidentiality Exercise good judgment, no matter which media is used Patient Health Information Proprietary Business Information Confidential (Employment, Medical Staff, etc) Sensitive Issues and Matters 8
Going Viral: London Health Sciences Centre public perception of a young patient - severe and progressively deteriorating condition Hospital confronted the ethical concerns and misinformation circulating on social media sites after they reached the attention of traditional media initiated their own social media campaign to address misperception and defend itself 9 Transparency on Facebook by Seattle Children's Hospital on Friday, October 1, 2010 at 8:20am To our friends and supporters, As many of you are aware, a recent error at our hospital resulted in the tragic death of one of our patients. Yesterday, we met with local media to share two additional incidents one involving an infant, and another involving an adult. We bring you this news with heavy hearts. All of us here are deeply saddened by these events and wish to extend our heartfelt apologies to the families involved. While we cannot minimize the pain these families feel, we are doing everything in our power to support them in their time of grief. They go on to describe what has been put into place to make sure this doesn t happen again! 10
Social Media Across the Care Continuum Worried Well Pre-Treatment Active Treatment Post Treatment Patients & Family Create a sense of trust that this is the provider of choice by beginning to deliver a smart and personalized experience Engaging disease/condition information Self-management tools Physician blogs Maps & directions Virtual tour Health tips Following tweets Clinical trial recruiting Educate and prepare for the what, where, how and why of treatment Self assessments Social support & networking Campus & indoor navigation Interactive learning Multidirectional information sharing Text reminders Provide the right support at the right time in the right way to improve the patient s treatment experience Journaling Social networking Interactive learning Messaging Bookmarking & organizing information Care coordination Patient generated data and information Caregiver support Support a positive return to life experience Reminders & monitoring Self-care tools Messaging Social support & networking Sharing story & feedback Ways to give back Ongoing engagement Copyright 2012 Tower Strategies DRIVERS & TRENDS 12
Key Healthcare Trends Paying for value Population health management Mobile Visuals Social gaming Rising consumer expectations 13 American Consumers & Social Media 50% prefer a health provider social networking site 14% prefer an integrated approach of hospital websites and social media 57% say a hospitals social media connections would strongly affect their decision to receive treatment at that facility 81% feel a strong social media presence indicates a hospitals clinical functions are cutting edge 14
Early Adopters of Emerging Technologies* The Young Family caregivers Patients with complex and chronic needs Minorities Medicaid beneficiaries Relative to context, condition/diagnosis, and environment *Use among older adults is growing 15 16
Engagement & Access Tools to document and transmit information Self-care tools for patient-centered care and chronic disease management Extend easy access to peer coaches (volunteers) 24/7 support available when consumers need and want Recognize the impact of mobile health smartphones, tablets, underserved populations 17 MU: Engage Patients & Families Online/electronic access core objective for meaningful use Messaging - preferred communication medium (multichannel) Self-management tools for patients with high priority health conditions Patient-specific educational resources Online reporting of experience of care measures Upload & incorporate patient generated data into EHR & clinician workflow 18
Enhancement to EHR Can t anticipate every question EHR information is rarely written in way understandable and actionable for patients with basic or below basic health literacy (90M) Too often include long text and use of medical terms Estimates of 77M people with a poor understanding of basic medical vocabulary and health concepts (at greatest risk for poor outcomes and readmissions) 19 Readmissions CA s goal is to reduce readmissions by 20% Average readmission costs $8000 to $13,000 Common drivers identified for readmissions: Lack of standard discharge processes Lack of engagement or activation of patients and families Patients call 911 or return to emergency room instead of accessing a different type of medical service Ineffective or unreliable sharing of relevant clinical information Patients did not understand/did not correctly take medications. 20
Readmissions Opportunities Causes Heart Failure and Pneumonia (50%) COPD (16%) Diabetes (13%) 51% of discharges did not have timely follow-up within 30 days* 10 times more likely to be readmitted Non face-to-face Transitional Care Management 21 Engaging with Social Media Audio, visual and spatial media simulation, process guide Widgets interactive forms, survey, self-assess, etc. Blogs journaling and communications Microblogs reminders, messaging, shift bidding, etc. Social bookmarking/wiki- saving, organizing, searching & sharing online information Social networking support & self care 22
Push Content & LISTEN 23 Social Media Learning & Influencing Identify attitudes, perception and behavior about brand and trends Social intelligence listening posts across the spectrum of social media outlets (today s newspaper clipping service) Social customer relationship management (CRM) Word of mouth promotions 24
What languages does your community speak? 25 Educating Floyd Medical Center Preoperative Patient Guide Boston University Discharge Advocate Education & aftercare plan encourages patients to be active participants helpful with low literacy 51 min vs. 81 min for live DA preferred by 74% of patients 26
Social Networking Dallas Children s Secure Patient Family Social Network Recovering from addiction(s) Access to support 24/7 Case managers track across transitions filter activity to assess risk of relapse Prioritize outreach activities 67% reduction in readmission rates for those out of treatment for more than 270 days 27 Social Networking Continued Northern California Health Centers Deploying a private social platform designed to: extend care patient engagement outside of provider visits And, others! 28
Extending to Mobile: Texting 90% of text messages are read within 3 minutes Secure, encrypted, protected, traceable texting apps for physicians, nurses and other staff communications Bandwidth: 1-minute call = 800 text messages Text 911 by mid-2013 29 Texting For Health sunscreen reminders for young dermatology patients what to expect and healthy behaviors for prenatal teen/young adults reminders of screenings, tests & tips for diabetics reminders about important follow-up appointments for opiate addicts HIV messaging for military personnel in remote areas 30
mhealth Apps by Category Verisoni, 2012 31 BUSINESS & OPERATIONAL ISSUES 32
Managing Threats & Risks Identify legitimate business uses & limit unnecessary risk Authority & responsibility Enforce existing policies Settings to access social media Monitor conversations - manage your reputation Safeguards to protect against viruses, malware, data breaches and malicious attacks 33 Planning Expectations Guidelines Behavior Policy & Training Safeguards Transparency Privacy 34
VA Directive and Policy highly encourage use of Web-based collaboration tools mandatory instruction for all VA offices & employees regarding the use of emerging Web tools policy on the proper use of these tools, consistent with applicable laws, regulations, and policies 35 Management Considerations Educate employees on social media and their HIPAA obligations Policy for managers re: LinkedIn Recommendations Effective leaders help employees manage their time! 36
Screening Potential Employees Make sure it is the same applicant Signs of poor judgment/communication Information prohibited from hiring decision Screening by neutral 3 rd party, not hiring manager Document legitimate reasons for not hiring 37 Avoid HR Minefields Organizing Activity Overly Broad Publically Available Discipline 38
Mobile Access Recognize appropriate business use of personal devices in the workplace Establish agreement with owners to: report if the device is lost or stolen allow remote erase (when devices are lost/stolen or upon termination of employment) follow established policies on use of personal devices use an access password on the device not store patient data on the device Balance usability, preferences, security, & budgetary concerns (BYOD) 39 App Regulation Draft Guidance proposes regulation of apps: Used as an accessory to an FDA-regulated medical device - enable a health care professional to view medical images on an ipad and make a diagnosis Transform a mobile platform into a regulated medical device - turns a smartphone into an electrocardiography, or ECG, machine to detect abnormal heart rhythms or determine if a patient is experiencing a heart attack 40
Best Positioned Hospitals Offer social engagement opportunities User-centered designs Benefit from resulting patient perceptions Leverage social media as a care coordination platform Change the way care is provided esp. post-discharge Use social intelligence and directed networks to advance goals 41 Christina Thielst, FACHE Vice President, Tower Christina s Considerations @TowerStrategies @cthielst cthielst@towerstrategies.com 805 845-2450 42