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Social Media: Friend or Foe?

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Welcome to Inova Health, Chris Boyer.

Just days after starting his job in April 2010 as director of digital communications and marketing at the delivery system, Boyer was startled to get the news that a baby had been stolen from one of Falls Church, Va. -based Inova's maternity wards.

Well, no. What really happened was that a hospital visitor overheard hospital personnel running a test-called a Code Pink-of a security system designed to prevent the crime. Thanks to the power of social media, the visitor was able to Tweet that a baby had gone missing and share the news with the wider online community.

Boyer was using a social media monitoring service and spotted the Tweet within minutes of its posting. He immediately called the hospital to confirm all the babies were still there, and just as quickly responded on Twitter with the facts. He won kudos from Inova's CEO for his prompt response, but even so, there's no telling if any damage was done to the six-hospital health system's reputation.

That walk on the wild side has not dampened Boyer's enthusiasm for Twitter and its multiple social media brethren, such as Facebook, YouTube, and LinkedIn-all ostensibly designed to facilitate communication, foster community and provide a new social paradigm. Inova is broadcasting on more than 30 social media channels, with multiple sites on Facebook, Twitter, and others.

Numerous physicians, hospitals and other health care players are trying to broaden their marketing and communications horizons by jumping on social media channels. Some see it as an ideal way to engage their patients and monitor public sentiment, and create a highly visible forum for their leaders to promote their services to local markets and beyond.

Those are the rewards if you can keep the genie in the bottle, but many organizations have had profound struggles doing so. Put aside the fear of flagrant, almost unthinkable, disclosures by clinicians (and they happen, see sidebar, page 28) and consider concerns about productivity issues wrought by excessive staff time spent on social media sites, and the blurring of professional roles with patients-who suddenly have become "friends" online.

In addition, know that once a public forum is established, feedback will not always be positive-or accurate, as Boyer learned. A basic example: If a patient is publicly naming names and complaining via social media about their care a hospital faces limits on what it can say in response. So while social media outlets can break down communication barriers and be extremely useful tools for community engagement, there's no controlling the medium nor the message.

A growing popularity

Despite the risks, more than 1,100 hospitals have launched efforts on the major social media outlets, according to Ed Bennett, whose 2-year-old Web site, "Found in Cache" (available at ebennett.org), tracks the industry's social media adoption. The proliferation of social media channels is one drawback encountered trying to craft a cohesive online presence, says Bennett, the director of Web technology at the University of Maryland Medical Center, Baltimore. "There are so many social media tools, it is like walking into a four-star restaurant with a thousand ingredients and told to go cook," he says. "The services are free, but to develop them, you need time and resources. That is a precious commodity for most hospitals."

The impetus to embrace social media stems from its undeniable popularity (Facebook says it has 750 million users worldwide). Consider Mayo Clinic, which has jumped into social media wholeheartedly. Mayo runs a Twitter feed with some 200,000 followers, maintains several blogs and supplies videos to a dedicated YouTube channel, says Lee Aase, director of Mayo's Center for Social Media. Launched one year ago, the center tends to Mayo's multiple social media outlets, as well as providing resources for others in the industry. The center's adjoining Social Media Health Network is a dues-based membership group that numbers nearly 80 health care organizations, including Inova and Catholic Health Partners.

For Aase, social media supplants conventional marketing practices. "We have not done appreciable advertising. For more than 100 years, word of mouth was how you found out about Mayo," he explains. "Social media is the new way that happens."

Indeed, Mayo demonstrates the technology's raw viral power. A video shot in 2008 of a couple playing the piano at Mayo Clinic has drawn more than 7.6 million views, Aase notes. But not all the content is so light-hearted: Mayo also creates videos for its YouTube channel that address specific diseases, such as myelofibrosis, a blood disorder. Such videos fill a void in mainstream media outlets, Aase says. "No way will the Today Show do a segment on myelofibrosis. It does not appeal to the mass audience," he explains, adding that Mayo's video-one of 1,500 the hospital created-has logged 9,000 views.

Social media is considered the communications vehicle of choice among young people-Facebook, to recall, began as social site for Harvard students.

So it's no surprise that hospitals catering to the young have embraced it. Children's Hospital Boston has used social media for several years as a marketing tool, says CIO Dan Nigrin, M.D. "We saw the value early," he says. "We have bragging rights because we have more Facebook friends than any other hospital in the country."

Nigrin's assertion appears valid. Through mid-July, Children's had logged 660,000 people who "liked" its corporate page. An analysis of data on Bennett's site shows that during the past year, Children's Hospital Boston surpassed St. Jude's Children's Research Hospital as the leading Facebook presence among hospitals. Through mid-July, St. Jude's had 446,000 Facebook followers. Arkansas Children's Hospital came in third, with 94,000 followers.

Typical of the genre, Children's Hospital Boston's Facebook page includes a wide variety of videos, discussion groups and photo albums. Hundreds of comments are posted by patients, some facing surgery and reaching out publicly for support.

It's that very outreach capability of social media that has prompted some hospitals to use the platform as an executive forum.

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