I received several questions and will repeat them here to give more complete answers:

1. What to you mean about the risk of conflict of interest?
   Because social media is largely brief communication, a physician or other healthcare professional could promote a product or service without a disclaimer that they have a financial interest in this product. To be transparent about potential conflicts of interest in social media, one must add a link to a webpage with full disclosure. Drug and device companies must be clear about any claims they make on social media and should link to more complete information.
2. There are so many social media outlets, how do you choose where to start?
   Find the best tool for what you need. It is not necessary to use multiple social media tools. For instance, if you are a physician or healthcare professional and want to communicate with colleagues, use Twitter if you are comfortable with more open communications, use a private social network for your group only if you would rather keep private. If you are a hospital and want to interact with patients, consider Facebook because it is an open, widely used platform which allows comments from patients.
3. In Spain there is a publicly supported healthcare system, unlike the US. How should the approach to social media be different?
   I would think hospitals would still want to hear from patients but would not use social media as a means to attract new patients unless there was a specialty service that more patients should be made aware of. A good example of this is http://www.guiametabolica.org/ which is also being presented at the conference.  Social media could also have more of a public health approach – how to keep the population healthier and identify diseases earlier for intervention.

Here are the slides from the presentation. And the video is below:

• Extended Care eVisits
• Home Telehealth
• In-Car Telehealth
• Medication Adherence Tools
• Mobile Asthma Management Tools
• Mobile Cardiovascular Tools
• Mobile Clinical Decision Support
• Mobile Diabetes Management Tools
• Social Media Promoting Health
• Tele-Stroke Care
• Virtual Visits

Social media for promoting health was put in class IV. They note that some “their goal is to give simple daily challenges or “micro-actions” that add up to significant health improvements over time.”  They report that their is a lack of evidence of effectiveness because they are so new and reports of success are mostly anecdotal by the vendors themselves. The exception are some studies of smoking cessation. While there may be a limited number of randomized clinical trials in the use of social media, there is a growing evidence of the effectiveness of social media in healthcare. Also, social media in healthcare is much broader than promoting health.  Online communities, apps, and Twitter are powerful tools capable of having a significant impact on managing and coping with illness. Also, increasing evidence is being published weekly in journals like Journal of Medical Internet Research and the Journal of Participatory Medicine.

Conclusion: this report has excellent analysis on several underutilized technologies in medicine but the evidence for the effectiveness of social media is stronger in my opinion.

Coincidentally, I attended the Cleveland Clinic Patient Experience Empathy and Innovation Summit on Sunday.  One track in the afternoon was devoted to social media with a good mix of speakers covering the latest trends in healthcare and beyond. Check out the Twitter stream here.

But hospital reputation is not the only use of sentiment analysis in health care social media. What are sentiments about diseases and conditions? In a brief check, cancer was more positive than cancer. But some comments are mixed, “thanks love! My roommate got diagnosed with cancer” is rated positive. My conclusion, sentiment analysis in healthcare requires fine tuning – what is good news, what is bad, what is neutral? The temporary pain of treatment can be a real downer but the results a real high. I will be interested to see more written on this in the future. Some research has begun, such as, this article on cancer survivorship.

• West Wireless Health Institute which has a good handle on new care delivery models
• Secondary Uses Service, description and and access. | The NHS Information Centre - glad to see the National Health Services is utilizing EMR data for quality and research
• National Center for Advancing Translational Sciences or NCATS - the new NIH center replacing the NCRR which inlcudes the Clinical and Translational Science Awards which I am now a part of
• A post on O’Reilly Radar - Epatients: The hackers of the healthcare world
• Eye on FDA - the new FDA blog
• CIRD – Partners HealthCare Clinical Informatics R & D

• Big Data and real-time analytics and decision support – IBM Watson and Explorys are in this space, others will follow and adoption will grow enabled by cloud computing, NOSQL/Hadoop and natural language processing
• Continued focus on EMR adoption as more health systems pursue meaningful use. This will again be the main focus at HIMSS as well as other conferences
• Social media in health care will continue to grow among patients as the e-Patient movement continues to gain in strength and public awareness and as advocates like the Reshape Innovation Center find creative uses to influence the future of health
• Mobile health and apps usage will expand but what is needed is a way to integrate personal health information, such as, PHRs and apps that promote wellness and disease management. For health care professionals, apps and mobile devices need to be integrated into clinical workflow rather than being an adjunct or distraction
• Research will be further enabled by EMR data as more academic medical centers develop data warehouses for research and quality studies and as initiatives like QueryHealth make it possible to combine data across systems and states using health information exchange and other tools

There are many more but these are the primary one’s I will be following.

• Appointed as the Co-director for Biomedical Research Informatics for the Clinical and Translational Science Collaborative, an NIH funded program through the Case Medical School
• Joined the Editorial Board of Tech Now Briefs of the American Association of Medical Colleges
• Invited to contribute to a theme issue on social media for Frontiers from the American College of Healthcare Executives
• Became a featured blogger for HealthWorks Collective
• Appointed as a reviewer for HIMSS 2012 abstracts – a new role for me
• Authored chapter on eResearch to a book on medical informatics to be ePublished in 2012
• Celebrated 30 years as an employee at Cleveland Clinic
• Leading a project to develop a clinical data warehouse for research
• Approaching 1000 connections on LinkedIn (969)
• 2881 followers on Twitter
• Klout score hovering around 42
• Invited to be on the advisory board of a health related startup

• February – HIMSS Annual Conference in Orlando – spoke at the Social Media center twice and presented on a panel on social media
• March – AMIA Clinical Research Informatics Summit in San Francisco. Two podium presentations (CKD Registry and REDCap business model) and two posters
• April – attended TEDx Maastricht in the Netherlands and a side trip to UMC Radboud in Nimegen.
• April – ACRT meeting (Association for Clinical Research Training) in Washington, DC – panel presentation on REDCap.
• May – Patient Experience Summit at Cleveland Clinic with Enoch Choi presenting
• June – consulting at a hospital in Michigan on data warehousing
• September – Medicine 2.0 Congress in Palo Alto, CA. Poster presentation
• October – American Association of Medical Colleges meeting on Big Data in Washington, DC
• October – Clinical and Translational Science Awards Informatics meeting at the National Institutes of Health. Bethesda, MD – poster presentation
• October – Panel at Case Medical School, Cleveland on Social Media in Clinical Trials
• November – Senior Workers Conference in Minneapolis, MN – presentation on Social Media and Electronic Medical Records
• December – Center for Health Services Research and Policy at MetroHealth Medical Center, Cleveland, on Disease Registries using EMR Data

Among the many uses of social media here, I personally think how patients and families engage with a large, academic medical center through Facebook demonstrates engagement best – they use it as a vehicle to show how grateful they are for the medical care and kindness of our physicians and nurses.

This publication is primarily for members of the ACHE but can be purchased. The five articles are a great overview of social media in healthcare currently and could provide a helpful introduction to healthcare leaders in your institutions.