Just my two cents

Musings on social media and the world as I see it


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Managing a hospital crisis in the new media world

A crisis. Most hospitals have one at some point. If your organization hasn’t faced one yet, it will. Whether a local disaster fills your ED to overflowing or a sentinel event occurs and makes the headlines, your staff and your board will need to know what happened, and the media will probably be camped outside your front door. For the communications team, it’s all hands on deck.

While every situation is unique, when it comes to communication surrounding a crisis, there are general rules that apply to all. I believe that being visible, honest and timely are the most important.

In a crisis, the last thing you should do is assume it will all blow over, or that word will not get out. Definitely not true, particularly in the age of Twitter, Facebook and other forms of social media. Playing possum will not make the situation go away. To use an old advertising tagline, “inquiring minds want to know.”

When something happens in a hospital, you need to quickly assess the situation, develop your course of action and key messages, identify the best spokesperson and address the situation head on.

If you’re not visible and discussing the matter publicly, you’re leaving the facts open to interpretation. So many recent scandals provide the support for this argument. Consider Tiger Woods, who still hasn’t spoken publicly, and South Carolina Gov. Mark Sanford, who disappeared for days and was less than candid about his whereabouts. This isn’t exactly the best approach when responding to a crisis.

Being honest
While there may be details that should not or cannot be made publicly known about the situation at hand, recognizing the situation, taking responsibility for the event and providing the overall facts are absolutely for any crisis response, regardless of your audience.

A crisis can damage a reputation quickly, but not recognizing the crisis or not responding can be even more damaging. An appropriate response can go a long way to maintaining or rebuilding trust.

Of course while some things are more easily forgiven than others, an “I’m sorry” can go a long way toward rebuilding trust with your community (consider the legislation now being proposed to make the “I’m sorry” clause for doctors a law). Public recognition of the situation and the apology must come from a trusted source, and determining the appropriate spokesperson can greatly impact the success of your crisis communication response.

Being timely
The concept of “timely” has changed quite a bit in recent years. Five years ago, your crisis response would be timed to a news cycle, with your internal audiences of staff and the hospital board notified in advance of the general public. But that news cycle no longer exists with the rise of social media. Information flows 24/7 and it is not from typical news sources. The emergency plan landing on New York’s Hudson River and news of Michael Jackson’s death, for example, were both reported first on Twitter.

When a crisis happens in your hospital, there are lots of people examining the situation from many angles – senior leaders, risk management, legal, medial directors, communications/media relations, etc. This will have an impact on just how timely you can be, but it is the communications professional’s responsibility to produce the right communications at the right time.

Given today’s myriad of communication tools, you should make use of all of them to get your response out there. If you provide a statement to the media, post it on your web site. If you have a recorded message from your president, post that on your web site and link to it through Twitter. If you have a Facebook account, post your video there and post your official statement on your Facebook fan page.

Remember — it’s about being visible, honest and timely. And because of the way news is now communicated, you must assume that your audience is not just local anymore. Sending a statement to your local television station or doing an interview with your hometown paper is not an adequate response. In a true crisis, you can expect e-mails and web postings from people internationally who may have never heard your brand name before, but they will now. That is the world we live in today.

So those are the basic rules. Are they always followed in every situation? Unfortunately, no, but they should be!

This post was originally written for and appeared on www.hospitalimpact.org.


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Why is it so hard for hospital staff to follow HIPAA rules in social media?

HIPAA is a common term in hospitals. If your hospital or health system is like ours, you spend a lot of time training, reminding and testing all employees on what is covered by HIPAA laws. For the most part, I believe employees understand the law and what they need to do to protect our patients and their privacy. Hospital employees sign agreements and promise to uphold their end of the deal, realizing there will be consequences if there are violations.

But for some strange reason, when it comes to social networks, employees seem to forget they are bound by those same regulations.

There have been numerous reports of breaches of patient privacy through social media outlets lately. Just this week, the LA Times storyreported that staff members were fired from St. Mary Medical Center in California, and another three were disciplined after posting photos of a dying man on Facebook rather than treating him.

In June, Tri-City Medical Center, also in California, terminated five employees and disciplined another after discovering they used “social media to post their personal discussions concerning hospital patients.” The hospital issued a statement on their website apologizing for the breach and how they were addressing it. (Applause for the transparency!)

As disturbing as they are, stories like these and others are popping up in the national news and it’s unsettling for everyone. There is something to learn from this though, and it is not that we need to ban social media from our hospitals. Social media is a powerful, evolving medium that allows us to communicate vital information and to hear from, and engage with, members of our communities. It should not be ignored. In fact, I strongly believe it should be embraced by hospitals as another way to reach out to their communities.

The stories of these breaches simply underscore the vital need for having strong policies in place that address the use of social media within and outside of the hospital. Employees need to know and understand that they are accountable for upholding the HIPAA laws even when they leave the hospital. That includes when they enter chat rooms, social networking sites or even their own blogs. In addition, human resources departments must be on board in recognizing that HIPAA laws extend to the use of social networks and any breaches of patient confidentiality through these means will result in disciplinary action.

Ed Bennett is the director of Web strategy for the University of Maryland Medical System. He also manages a blog which provides a wealth of information on hospitals and social media. The site provides a nice list of publicly published policies. It’s a great resource for hospitals, and can help in developing a new policy or tweaking an existing one to address social media specifically.

I am still confused as to why hospital staff members would ever think it was okay to reveal privileged patient information through any means, especially one as public as social media. Perhaps these changes in the way we communicate call for not only new and revised policies but also for additional training and signed agreements for staff to further understand the ramifications of violating HIPAA through social networks. What are your thoughts?

This post was originally writtten for and appeared on www.hospitalimpact.org.


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Allay fears and build loyalty in a crisis through social media

Hospitals are not exempt from the economic woes our country is facing. More and more, we hear of hospitals facing layoffsto address budget deficits. This can undoubtedly cause concerns among patients and members of the community. They may worry about whether they will be able to get the care they need if your hospital appears to be downsizing.

Hospitals that use social media for marketing are often inclined to NOT use these tools during difficult times. Take these two instances:

Let’s look at St. Francis Medical Center in CT. Earlier this year, the hospital laid off 200 of its 3,500 staff, according to this Hartford Courant story. Searching the hospital’s website, I could not find any information on this major news. The hospital also has a Facebook page, although there was nothing posted over the months when the layoffs took place. An article on the Hartford Guardian site indicated that there was a written statement, but I never found any comments directly from the hospital through a Google search.

Last week media reported that UMassMemorial Health Care in Mass. would lay off 350 of its staff. A tour of the system’s website and online newsroom turned up no information on the announcement. While they are not on Facebook, they are on Twitter. A quick glance of their timeline shows no response at all to the news of the layoff, although there were several tweets the day of the Boston Globe story, but not about the hospital’s situation.

While it may seem counter-intuitive, tough times are the perfect opportunity to use social media. Both Twitter and Facebook can serve as customer service tools, a vehicle to promote your quality of care, a way to be transparent with your staff and your community, and a way to allay fears and continue to build loyalty within your online community. It’s also a way to get your message out in your own words.

The use of social media needs to be based on openness and honesty. It’s important to recognize not only the good but the bad. Issuing a statement or press release to the media is fine, but in today’s social media savvy world, people are tweeting and posting on Facebook and leaving comments on news sites about your hospital and the news that was generated.

It’s important that you be part of the conversation and not appear invisible, or appear to be ignoring it. Let’s take the example of Beth Israel Deaconness in Boston earlier this year, when its CEO, Paul Levy, was in the news for a “lapse in judgment.”

Originally, the story played out in the media with written statements and interviews with hospital PR folks. This seemed out of character for Levy, who has been a strong advocate for transparency, on his well known blog, Running a Hospital. In his post called “Going Public,” he stayed true to form and was open and honest about the situation, and gained a lot of respect in return. I, for one, saluted him and was relieved to see that he had not cast his belief in open communication to the wind when confronting a crisis!

I believe that addressing both the good and the bad is vital when it comes to having a presence in social media. It’s critical to continue to have a presence during difficult situations, and respond to concerns. It’s an opportunity to show that you recognize those concerns.

It really is okay to show you’re troubled by the event or situation, just like it’s okay to apologize when mistakes are made. But it’s also a chance to show what you’re doing to address the situation and allay the fears that patients and their families may be having.

What can you do in tough times? Build a page on your website to show what you’re doing to address the situation, use Twitter and Facebook to post information that shows you’re recognizing and addressing the problem, and point people to the information on your website. It’s also an opportunity to encourage feedback. Knowing what people want to know can help you tailor your message and directly address what they are worried about.

It’s time to embrace social media, because that’s where the world is turning for information. Hospitals are no exception.

Have you seen good examples of a hospital using social media in an internal crisis? Share them!

This post was originally written for and appeared on www.hospitalimpact.org.


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Social media’s evolving role in health care

The past few years have been quite a whirlwind in the communications and marketing field, and the hospital sector is right in the middle of it all. Despite patient privacy and some resistance, social media has taken hold as a vital part of our everyday lives in the world of healthcare and hospital communications.

Its humble beginnings may be traced back to something as simple as a Mayo Clinic video of an adorable couple who played piano in the atrium. I don’t think anyone, including Lee Aase, had any idea that this would grow into something as big as it is, with now over 7 million views.

Now, Aase and the folks at Mayo have become known as leaders in the use of social media in healthcare, and this year launched a first of its kind Center for Social Media, which I’m sure will lead the way in the future.

How hospitals use social media continues to evolve. We’ve come to realize that we can have fun in this technological world while still getting a message across. St. Vincent Medical Center’s Pink Glove Dance video gave the hospital an opportunity to spotlight staff from every area of the hospital while promoting breast cancer awareness. With more than 12 million views, it was so successful, they went ahead and made a sequel. But this one is a compilation from hospitals in the U.S. and Canada, with staff and survivors donning their pink gloves and dancing in the mission to raise awareness and show breast cancer patients they’re not alone. Brilliant!

While not quite as fun, hospitals are also using social media in incredibly practical ways. Scottsdale Healthcare was the first to post ED wait times on a website, and others like the Akron General Health System are also doing this on Twitter and Facebook. Some people have expressed concern about this practice and have written articles like the one in American Medical News(and on iHealthbeat at the previous hyperlink) arguing it could discourage patients from seeking care when there is an extended wait.

Social media and crisis situations seem to be a natural union. The quick, accessible media allow someone within a hospital to post quick updates as information breaks. Some hospitals are to be commended for their clear-thinking and rapid-fire approach to using social media during these times. Those that come to mind are Scott & White, during the Ft. Hood shootings , or Johns Hopkins tweeting and posting updates on their website during a hostage/shooting situation.

Hospitals are now hiring social media managers like Dana Lewis at Swedish. Dana is the perfect person for this position, and in a tweet said she can’t imagine being anywhere else. With the focus on engagement and conversations growing by the day, this is definitely a smart move. Promoting fundraising events is also a natural, because you’ve already got a captive audience of followers.

So what does the future hold? The possibilities are endless.

  • Tomorrow’s Facebook can be a storefront for a hospital complete with secure checkout for cause marketing related sales (think selling Christmas ornaments that benefit the hospital right from your Facebook page!).
  • Find and recruit patients who are willing to tell their stories in videos, or become advocates who can serve as defenders of your reputation when a crisis hits.
  • Use Twitter and Facebook to conduct focus groups on new ads, mission statements, etc.
  • Offer a formal complaint process through Facebook.
  • Use social media as THE internal communications process for staff.
  • Offer mobile apps that allow users to track their status for certain conditions and report directly to their physician (this may actually already be in use).

How else do you see social media evolving among hospitals?

This post was originally written for and appeared on www.hospitalimpact.org.


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Hospitals that excel in social media

Most of us in the healthcare field who are using or interested in social media know of Ed Bennett and his fantastic blog, Found in Cache. If you follow his blog and its regular updates of the big social media list, you know that more hospitals are jumping into social media.

As of January 23, 2010, the list includes 906 hospitals using 3,087 social sites. Of course, just because a hospital is using social media doesn’t mean it’s successful at it. So I decided to look at some of the top hospitals and see what they’re doing, what sets them apart, and what makes them so successful.

First, I realized that I’m falling behind the curve, because not only have we not launched a blog, but we haven’t claimed our hospitals on Foursquare (a location based social networking site that allows users to “check-in” to places they happen to be visiting, dining, receiving care, etc.), , and we haven’t established LinkedIn accounts for the hospitals either. Many hospitals are using all of these social media outlets and more (FlickR, YouTube, etc.) to build a loyal following and talk to people about what matters to them. And clearly there are leaders.

On Twitter, in terms of followers, Mayo Clinic is the leader of the pack. No surprise there. They’ve been considered the leaders in social media for hospitals for a long time, thanks to Lee Aase. Mayo now has nearly 120,000 followers through 2,815 tweets. So what are they doing with their tweets? They provide quick, helpful health tips, promote sources of getting health info like podcasts or interviews with their experts, they solicit questions from people, promote videos, and call attention to media stories. It doesn’t seem like anything unusual, though. So what am I missing? You can’t help but wonder if their well-known name helps with increasing followers.

On Facebook, Mayo does well here also, with nearly 22,000 “likes,” but that’s just a drop in the bucket compared to the leaders. Tops is Children’s Hospital Boston with 500,537 likes, or fans, as of February 7. So how did they get there?

I absolutely love what they’ve done. When you visit their Facebook page for the first time, you’re invited to like them to read patient stories and submit your own. Brilliant. Their tabs are pretty standard, but they also have a “Give” tab to support philanthropy, their “photos” tab has 65 albums, with an additional 1300 or so posted by fans, and they also have an “Invite” tab that allows you to invite your own friends to become a fan. Apparently it’s working.

Next on Facebook is St. Jude’s Children’s Research Hospital. They boast a whopping 358,154 fans, or likes. It doesn’t hurt that they advertise nationally and of course childhood cancer tugs at the heartstrings. But what are they doing on their Facebook page to set themselves apart? They’ve got a special tab for “Patient of the Month,” a customized tab with a timely promo called “Game Day. Give Back,” and a “Shop” tab to purchase items from the hospital that support its fundraising efforts. If you look at their wall, it almost appears to have more posts from fans than from the hospital itself. It’s a truly impressive effort.

Also of note, the third on the list is another children’s hospital, Arkansas Children’s, with 77,791 fans/likes. It seems that social media and children’s hospitals are a natural. It’s an engaged audience with lots of moms on social sites sharing info and experiences, gathering tips, and discussing their own stories. Seems like a perfect match. In my own experience, Hasbro Children’s Hospital is far and away the most “liked” and the Facebook page with the most engagement of our five hospital accounts.

What I find interesting, though, is that the hospitals are all doing very similar things. Yet clearly, we have some that are excelling in terms of engagement and followers. That leads me to a question: Is name recognition and reputation an important aspect of social media success, or can a small community hospital build such a following simply by doing the right things? I’d love to hear feedback on this topic and get a discussion going. And in my next post, I’ll be taking a look at hospitals using LinkedIn and foursquare–a rapidly growing list.

This post was originally written for and appeared on www.hospitalimpact.org.


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Healthcare checks into Foursquare

I have to admit I am NOT a Foursquare user–that is, until today, when I signed up to do some research for this post. For those who don’t know about Foursquare, it’s a location-based application that allows you to build a network of friends through your email, Facebook and Twitter accounts to see where your friends are, and also “check in” at venues, restaurants, airports, malls, etc. (Here’s a great overview.)

Either I’m in the minority–I’m not as tied to my phone as I could be–or I’m just too old, but I never understood the need to continually proclaim my whereabouts or why anyone would care (unless they wanted to rob my house when I announced I was at the airport waiting for a flight). I guess for people who have active social lives or travel a lot it can be fun and helpful, but I don’t fit into that category. I also have to admit I get a bit annoyed when Twitter feeds or Facebook walls are crowded with “I’m at Joe Schmo’s Bar and Grill with 4 friends.”

But when I saw Foursquare posts in Twitter searches that showed people checking in at our hospitals, I became a bit more interested. Now, I’m glad these posts show up in Twitter and Facebook feeds, because I can respond to anyone who’s checking in to make sure things are OK, or just send best wishes. It’s actually resulted in some nice conversations.

I’ve also come to understand why businesses care about this particular social network. It’s a virtual gold mine when it comes to finding out who your customers are and building loyalty/rewards programs for them. Things like “get a free sandwich after your fifth check-in with us” at your local deli or “get an upgrade to first class after 100 check-ins on our airline” (ha!) can easily build customer loyalty. It can also generate testimonials from devoted customers who are tweeting, Facebooking and Foursquaring the brand name to their network of friends–and we all know the most trusted form of advertising is recommendations from family or friends. From this standpoint, I completely understand the benefit of this unique social network as a marketing tool.

Yet, it still eluded me how Foursquare could benefit the hospital sector. Sure, Facebook and Twitter make sense, but how could a hospital possibly use this tool? Then I saw a post by Ed Bennett on his Found in Cache blog, where he notes that while not all hospitals have claimed their venue on Foursquare, “almost every U.S. hospital has a Foursquare venue.” In Ed’s ever-expanding look at hospitals using social media, he has added a list for Foursquare, noting the number of unique individuals who have checked in at a hospital, the total number of check-ins, and whether or not the hospital has claimed its venue.

According to Ed’s list, as of January, around 60 hospitals had claimed their venue. That’s a very small percentage. But here’s what important to note: if you’re a hospital and your venue hasn’t been claimed, that doesn’t stop people from checking in. More importantly, they can leave comments.

I have not yet claimed the venues for the five hospitals for which I manage social media. But when I looked at the venues, to my horror, people had commented–both good and bad–after checking in at some of them. This is something I’ve totally missed until now, and since I’m committed to responding to all mentions of the hospitals, I’m breaking my own rules by not being involved in this network.

The problem with Foursquare is that unless you check into a venue, you don’t know what that particular venue is doing in terms of customer awards; so I still remain stumped as to how this can benefit hospitals. But as I mulled this last week, I saw this tweet from Shawn Wells at Sarasota Memorial in Florida (@SMHCS on Twitter):
“Next time you visit #Sarasota Memorial Hospital, check in on #foursquare and have a #Starbucks on us. http://4sq.com/igFS84 #bradenton.”

Brilliant, I thought. Getting people to check in helps you identify people who are coming to your hospital, who may be commenting on your service or treatment, and who may be recommending your hospital to friends and family–or maybe not. It’s a way to build yet another relationship with someone in your community. The light bulb over my head finally went on. Thanks, Shawn!

A further search on Twitter for “Foursquare and hospital” found a few tweets, but that was the only one I found coming from a hospital asking users to check in with them. So, that leaves me still wondering how other hospitals are using Foursquare as part of their overall social media strategy.

If you’re using Foursquare at your hospital, please let us know what you’re doing and how it’s working out. Either leave a comment, or feel free to email me at njean@lifespan.org . I’m sure I’m not in the minority of being very inquisitive about this network and how it can help hospitals as we continue to expand our reach into social media.

In the meantime, I will start checking into places I visit to see what happens. And I’ll keep my fingers crossed that I’m not checking into a hospital as a patient and no one is robbing my house.

This post was originally written for and appeared on www.hospitalimpact.org.


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Patient complaints: To delete or not to delete, that is the question

When we decided to add social media to our arsenal of healthcare marketing tools, we knew there was an inherent risk in doing so. We understood the potential of negative comments appearing on a Facebook wall, or a disgruntled patient tweeting about how many hours they’ve spent in our busy emergency department. But when it actually happens, it’s unsettling nonetheless.

In my own experience, we sailed along happily on our hospital Facebook pages for quite a while until one day we found a post that identified a doctor by name, and not in a flattering way. Thus began a series of many meetings and discussions and ultimately, the development of a protocol to address such negative postings.

As the hospital’s representative in the social media world, I understand that we need to expect these posts, and part of me feels that deleting a post is simply censorship. Deleting a post goes against the grain of social media, where people expect to have their say and be heard. Another part of me, however, understands that a doctor’s reputation is being called into question by one unhappy patient. And that is exactly why you need a policy for what is acceptable and what is not. But just having a policy isn’t everything. Let me explain.

Our policy contains some very straightforward information that nearly anyone can understand, followed by the more formal, legal jargon. Included is a section that indicates a user should not post anything that is “abusive, harassing, embarrassing, tortuous, defamatory, obscene, libelous,” etc. Seems clear, right? Well, we learned those words are very subjective. In my opinion, the post was none of those. In the doctor’s opinion, however, it was, and the doctor also questioned whether there was a legal avenue to investigate if the comment remained online.

So, what did I do? I listened to our department’s leader, of course, but I also listened to the doctor. Was it right that her name was being smeared on a public social site? Of course not, but the same could be done by a patient writing on a personal blog, writing on his or her own Facebook page, or going to the news with a sexy story about how he or she did not get the care that she felt was required.

In any case, it opened our eyes to the subjective nature of the policy, and it also led to a protocol being developed so that in the future, if a member of the hospital staff is identified by name in a way that COULD be considered as “abusive, defamatory, embarrassing…”, then the post would be removed and the user would be notified that the post was deleted because it went against the policy. The protocol, however, does allow for negative posts about the hospital in general or a particular department to remain online.

It was an interesting experience, and one that happened again just a few weeks later on another of our Facebook pages. This time it was a lot easier to recognize that it wasn’t censorship, but protecting the reputation of an individual physician. And I am quite happy that if I were on vacation, any member of the team who was covering for me would know exactly how to handle negative postings because of the protocol we developed.

But I’d be very interested to hear what other hospitals are doing. So what say you: To delete or not to delete? Do you agree with our approach?

(Written for and originally posted on www.hospitalimpact.org)


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So I lied…so much for not talking about social media!

In my first post, I said I didn’t feel like I had enough expertise to focus on social media. But tonight’s post is about just that!

I’ve been working in the social media arena for over a year now, and I’ve seen the power it has… from building brand awareness to getting information out, to taking the pulse of a brand’s reputation. But the REAL power of social media is in the connections — meeting people and sharing a meaningful interaction. Coming from the PR and communications side of healthcare for many years, this is pretty new to me, and is really my favorite part. I just want to share something that happened today, because it’s the inspiration for this post.

Today, I posted a status update on the children’s hospital Facebook fan page, asking for fans to contact me if they would like to help us spread the word about the hospital through media or fundraising by telling their story. I was contacted very soon afterward by a woman who told me a heart-wrenching story about the extensive medical care her twins have received. I was so amazed at the conviction of this woman to go out of her way to help the hospital. She is dealing with some very serious medical issues with her kids, yet she is organizing a fundraiser for the hospital and is more than happy to tell the story of what the hospital has done to help her beautiful twins. She even shared a picture of these adorable kids with me.

Therein lies the TRUE power of social media: Meeting people you otherwise wouldn’t have and sharing a conversation, learning something new, and getting a good feeling from what you are doing, knowing that in a small way, it’s making a difference.