How Should Hospitals Use Twitter?

Many U.S. hospitals are already on Twitter but most of them use it as a one-way channel. They just "push" updates to the followers without replying or making favorites to share with others.

Is this the best way to use Twitter?

Is it "creepy" if a hospital follows patients on Twitter?

It is OK for a doctor to follow his patients on Twitter? On Facebook?

See some parts of the Twitter discussion below (the oldest post is at the bottom, the newest at the top):

Ed Bennett
Ed_Bennett Last word. Hospitals follow patients = bad & creepy. Patients follow hospital = good. Hospitals monitoring social nets for problems = smart


Ves Dimov, M.D.
AllergyNotes @shamsha "how should hospitals use twitter?" - Twitter is not a PR release channel or RSS feed.


Ves Dimov, M.D.
AllergyNotes @shamsha "how should hospitals use twitter?" - They should follow, make favorites and respond. Not like @theeconomist: 0 following, 0 favs


shamsha
shamsha @allergynotes good ideas. getting them to respond might be the hardest part.

shamsha
shamsha @AllergyNotes sounds like a good blog post: how should hospitals use twitter?


Ves Dimov, M.D.
AllergyNotes @shamsha "thnx for posting the list about hospitals on twitter. hope this makes others join too" - They have to figure out how to use it too


shamsha
shamsha @AllergyNotes thnx for posting the list about hospitals on twitter. hope this makes others join too.


Ves Dimov, M.D.
AllergyNotes Updated: Top U.S. Hospitals Are On Twitter http://tinyurl.com/6a3pxr


Ed Bennett
Ed_Bennett Just created @HospitalGroup an account that only follows official Hospital twitter accounts. Have 35 hospitals so far.


From the comments:

"I think it is poor customer service to ignore that your patients, caregivers and whomever else are saying about you in twitter. Would you ignore someone in the hallway that looked lost, or was complaining about some service issue? Is it a breach of their privacy to ask them if they need help in an email, on the phone or in the parking lot?"

Please see the rest of the comments below for continuation of the discussion.

References:
Top U.S. Hospitals Are On Twitter
How are hospitals using Twitter....and is it really effective? Hospital Online Marketing Education.
A comprehensive list of U.S. Hospitals that use YouTube, Facebook , Twitter or Other Social Networks. Ed Bennett.
Image source: sxc.hu, free.

Related:
Hospitals have found Twitter. Should we be afraid? Chris Seper. MedCity News, 01/2009.

19 comments:

  1. Great! - A chance to expand my comments beyond 140 characters. I think hospitals should use Twitter in two ways.

    1. As one-way push of news releases, events information, health tips, and other items that might be of interest to a broad range of people.

    2. As a tool to monitor discussions of our hospital by anyone on Twitter. Are people pleased, upset, or confused by what you do? Is there an opportunity to solve a problem that someone is having with your hospital? Then offer assistance to that person, fix the problem and move on. This is customer support 101.

    There’s no reason for a hospital to “follow” their patients. It’s invasive, and doesn’t benefit either party. We are not the same as other businesses. We are not selling shoes like Zappos or Cable TV like Comcast, two examples of corporate best practices on Twitter. We are touching peoples lives at their most personal and vulnerable point – and that connection requires discretion and respect in our part.

    I believe that social networking tools like Twitter are the future of the Internet. But it’s important that we, as large, powerful organizations use these tools in a sensitive, understanding way. Respect the privacy and boundaries of our patients, and we will earn the right to be part of the conversation.

    ReplyDelete
  2. Ed,

    Thank you for your comment.

    (1) is similar to blogs and RSS.

    (2) is similar to Google Alerts.

    How is Twitter different?

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  3. How is Twitter different to a Hospital? It's not. It should be treated no differently than a RSS feed or Google Alert. It's just another platform.

    ReplyDelete
  4. I still think that Twitter may have more potential than "one-way/push-to-followers and data-mining channel" but I may be wrong. In any case, I tend to unsubscribe from publishers that use Twitter as RSS, for example, WSJ, BBC, CNN, etc.

    We don't have many examples of good use of blogging by hospitals either.

    I will be watching the space to see how the use of Twitter by the hospital evolves.

    Zappos CEO certainly gets Twitter. I've gotten several direct messages from him already. See here: http://twitter.com/AllergyNotes/status/1043879199

    ReplyDelete
  5. It's possible that Twitter could have more potential for hospitals, but do you agree that there is a difference between your hospital following you and CNN?

    Your hospital - the one that knows your most personal information, the physical conditions you have, and the medical procedures they've done on you. Do you really want them following your every comment on Twitter? I know I don't. If we don't recognize and respect boundaries, then we will be rejected by the patients we want to serve. If a particular patient asks us to follow them, then I might reconsider, but until then a conservative approach is best.

    ReplyDelete
  6. Re: "Do you agree that there is a difference between your hospital following you and CNN?

    Do you really want them following your every comment on Twitter? I know I don't."

    These are new tools and we are still figuring out how to use them best. You have a point with your concerns expressed above.

    I like it when companies I write about follow me on Twitter. Similarly, I will be happy if my hospital or my doctor follow me on Twiter. After all, they will know more about me as a person, and hopefully, will be able to treat me as one rather than just a number. "Scripts" like "we'll take good care of you here" can only do so much. A recent study showed that when radiologists matched X-rays/MRI/CT scans to patient photos, they performed better.

    Twitter may be a way for the hospitals to know their patients better and the patients may actually appreciate this. Again, we will see how the field develops. Your concerns are valid as well.

    ReplyDelete
  7. I agree with your comments - having your doctor/hospital follow you means that he/she is taking a deeper interest in your well-being. But, you should initiate the connection, not the doctor/hospital. And that invitation should be explicit. You following your hospital should not be a trigger for them to follow you.

    Also, I think there's a big difference between a organizational Twitter account like @ummc (my hospital) and a personal, individual account like @ed_bennett. Different rules should apply.

    ReplyDelete
  8. Great comments all.

    First, a 'follow' on Twitter, even if it's reciprocal, does not automatically denote 'active' monitoring of a person or organization's tweet stream.

    Some of us use Twitter actively, some do not (re: push/pull argument, there is no 'standard' use of Twitter for health, medical, or hospital tweets).

    Twitter is a channel, not necessarily the immediate genesis of either a two-way, reciprocal following or a two-way, reciprocal conversation.

    You can tune a pair of two-way radios to the same channel, but if the parties on either end don't find value in talking, you'll get white noise or a click as the power is turned off.

    As in any other way with which a hospital may communicate with me as a patient (email, web ad, print ad arriving in my mailbox, TV spot, radio spot, call after surgery to see how I'm doing, etc), I expect to be made aware of this option and have the option to close the conversation (deleting the email, ignoring the web ad, tossing the print ad into the garbage, changing the channel, etc).

    With Twitter, I have both. I can see that a hospital is following me, and may choose to block them. Same with a doctor who wants to connect with me on LinkedIn, Flickr, Twitter, etc. I will block them if I don't see value in that interaction.

    But, let me emphasize for the record here I'd *LOVE* to have my doc on Twitter. I'd love to be able to tweet to schedule an appointment. I'd love to be able to click a button on her LinkedIn profile to schedule a follow up, or access my PHR.

    Twitter is a lens, a gateway, not my end destination. I wouldn't imagine it would be very productive for it to be my doc's either.

    As Ed points out in his first comment above, a hospital can obtain value by monitoring Twitter without following a ton of patients (or even any) - you could just do repeated, regular searches using Summize/TwitterSearch for your hospital's name (and your executives names, as well as any branded campaigns you may be running, such as the JCAHO "Speak UP!" program).

    To the original questions at hand: If a company or person uses Twitter as a 'push' that's overbearing or not useful for me personally or professionally, I exercise my Twitter amendment rights and delete them.

    I don't find a hospital, even one of mine (UMMC) following me on Twitter (which they are doing) creepy at all.

    My larger question would be what value would they project from pulling staff to enable active following/monitoring of me as a patient? (I'll leave the remote monitoring uses of Twitter for home care with docs up to Ted Eytan to work out :).

    I would suggest for hospitals it may be much more effective to have BOTH a personal and professional/PR presence on Twitter - i.e. a staff person actively using the service a la @ed_bennett or @paullevy and a branded 'named' account only tweeting news, tips, etc.

    You can bet if something of relevance arises on Twitter they'll bring it to the attention of the appropriate persons/groups within their hospitals.

    And therein lies the benefit to me. If something is going wrong, and I can get a hospital's attention by tweeting about it as a patient, then this is one more channel for a hospital to utilize to improve performance and actively manage community relations.

    Look, bottom line with following me on Twitter: The hospitals have my medical records, and if they do a Google search for my name, will find far more information than by following my Twitter account.

    Again, since we have this happy shiny baby medium with which to play, let's try letting the individual patients make the choice.

    If it's ok for you as a hospital organization or hospital employee to follow us, we'll let you follow us.

    If it's not, most likely you and everyone else will hear about it in a tweet or two. Don't take away our options to interact with hospital healthcare personnel out of fear or a desire to impose boundaries we don't recognize.

    There's an easy way for hospitals and personnel to figure this out - ask us. Try a direct message: "Hi. I'm Super Hospital. I'd like to follow you. Is that ok? Here's who to call if you have questions."

    ReplyDelete
  9. Jen,

    Thank you for your thoughtful comment. It eloquently covers most of the points I wanted to make. You should think about expanding it a bit and publishing it as an article.

    Overall, I think the comment thread above should be a required reading for health organizations thinking about expanding their reach (and interaction) to include Twitter.

    Thank you all.

    I would like to connect this blog post/comments with Twitter comments because they naturally go together. See a few more responses to the question "What do you think of your hospital or doctor following you on Twitter?"

    DrGourmet @AllergyNotes As a patient, I'd be OK if there was a reason. I follow a lot of listserv to learn what patients need / are talking about.
    http://twitter.com/DrGourmet/status/1044086493

    wheezemd @AllergyNotes Doesn't bother me if my hospital or patients followed me.
    http://twitter.com/wheezemd/status/1044098031

    goldenskye @AllergyNotes Would my Dr *want* to follow me? Not sure. I wouldn't mind the follow but I know people who would not like it.
    http://twitter.com/goldenskye/status/1044055968

    markhawker @AllergyNotes re. @twitter Doctor. Do you mean GP? If so, I can't see point as do I need to be connected to him 24/7? Nothing I say on here is medically relevant nor does it correlate to my health. I'd rather interact in an ad-hoc way rather than connected. Plus, what about the hundreds of other social tools out there? How will they patrol all of those?
    http://twitter.com/markhawker/status/1044065061

    goldenskye @AllergyNotes @markhawker Agreed Mark. Your use of word 'patrol' is indicative of how many would feel.
    http://twitter.com/goldenskye/status/1044090484

    ReplyDelete
  10. Jen, You make some very good points and have given me a lot to consider. Let me address your main comments:

    ----------------------
    Jen said:
    "First, a 'follow' on Twitter, even if it's reciprocal, does not automatically denote 'active' monitoring of a person or organization's tweet stream."

    You and I may not see it as active monitoring, but we are both deep into the Web and the health care industry. We understand the basic underpinnings of this platform and what our actions imply.
    Not everyone would see it the same way.

    ----------------------
    Jen said:
    "Look, bottom line with following me on Twitter: The hospitals have my medical records, and if they do a Google search for my name, will find far more information than by following my Twitter account."

    That's true, but I'd be wary of any hospital that did such a thing. It's not appropriate. Just because we can do something doesn't mean it's right if we do.

    ----------------------
    Jen said:
    "Don't take away our options to interact with hospital healthcare personnel out of fear or a desire to impose boundaries we don't recognize."

    My conservative approach doesn't take away your option to interact - it respects it. This is not a situation when asking forgiveness is better than asking permission. It's a situation where I want you to feel completely comfortable and in control of my interactions as a hospital with you.

    ----------------------
    Jen said:
    "There's an easy way for hospitals and personnel to figure this out - ask us. Try a direct message: "Hi. I'm Super Hospital. I'd like to follow you. Is that ok? Here's who to call if you have questions."


    This is a great idea, it empowers the patient and gives them control over the process. I will start using this approach now. My only change would be to say:

    "We noticed you recently spoke about your experience at our hospital. We welcome you to follow our official updates at @hospital_name. If you want us to follow you, please let us know by DM. Here is my name and ph# if you have questions"

    This is simple and respectful.

    Jen - Thank you again for your thoughtful comments and ideas. We are all trying to find the best path with these new tools.

    ReplyDelete
  11. Could not agree more:

    "We are all trying to find the best path with these new tools."

    ReplyDelete
  12. I'm looking forward to making a blog posting about my ideas, just want to wait until I finish my conference abstract on it. I want to research and think it through. Thanks @allerynotes @Ed_Bennett and @shamsha for ignitiging this conversation. Also, my post will likely be from a culture, innovation and recruitment perspective.

    ReplyDelete
  13. Re: "@allerynotes"

    It's @AllergyNotes but never mind...
    http://twitter.com/AllergyNotes

    ReplyDelete
  14. Hi. I help update the Cleveland Clinic CME Twitter account. The goal of it is to be totally upfront and honest and provide information concerning Cleveland Clinic CME. The live courses typically have a registration fee associated but all of the online CME is free.

    As a newbie to all of this I would like to ask your opinion concerning this. Does it come across as we are just trying to sell courses or are we offering information that you find useful? Are we too narrow in our focus?

    My goal is to engage with our readers whetever level of engagement they bring to us. Any opinion is welcomed

    ReplyDelete
  15. Dear "Cleveland Clinic CME" person,

    As a former Clinical Assistant Professor of Medicine at Cleveland Clinic, I hold the ideals you mentioned above near and dear to my heart.

    Good options would be to:

    1. Ask those questions on Twitter itself.
    2. Try to engage physicians/nurses bloggers with suggestions for relevant courses by responding on Twitter or posting comments.

    ReplyDelete
  16. Cleveland Clinic CME (Pat)12/08/2008 1:23 PM

    Thanks for your reply. I have started asking these questions on Twitter since where better than getting answer than the people you are talking to. I do retreat from suggesting courses to physicians/nurses as I feel I am not being as transparent when I suggest CME courses from my employer (or at the very least perceived as being transparent). I think there is a very thin line to walk between helpful suggestions and really bad blog 'ads' for CME.

    ReplyDelete
  17. At M. D. Anderson we do use twitter to push information, but we have been exploring customer support with twitter for a least the last 6 months. It started for us with listening, and following twitterers who identified themselves as having a relationship with the hospital, and it has evolved with outreach when we think it is necessary and appropriate

    We wrote about some of our experiences here in CancerWise http://tinyurl.com/5jfg

    I think that there are some privacy issues that need to be considered, however I think it is poor customer service to ignore that your patients, caregivers and whomever else are saying about you in twitter. Would you ignore someone in the hallway that looked lost, or was complaining about some service issue? Is it a breach of their privacy to ask them if they need help in an email, on the phone or in the parking lot?

    Also, this discussion should not stop at twitter, should you ignore bloggers, or people who post in Yahoo answers? I must admit that we have not fully embraced the practice... But it is a practice worth exploring.

    ReplyDelete
  18. Jennifer Texada,

    Thank you for the excellent comment. I think you are quite write here:

    "I think it is poor customer service to ignore that your patients, caregivers and whomever else are saying about you in twitter. Would you ignore someone in the hallway that looked lost, or was complaining about some service issue? Is it a breach of their privacy to ask them if they need help in an email, on the phone or in the parking lot?"

    Many patients would appreciate this approach.

    ReplyDelete
  19. I saw an interesting article recently that talked about how Surgeons, for the second known time, Twittered a surgery to give short real-time updates about the procedure. I think privacy issues are the biggest concerns with this medium.

    ReplyDelete

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