The Advisory Board says that three things will be essential to successfully manage patient communities:

• Information-powered clinical decision-making
• Primary care-led clinical workforce
• Patient engagement and community integration

Engage patients and integrate communities

Your role will focus on engaging patients and integrating communities.

So what does that mean? To be successful you will need to develop three key skills.

Sound strategy

Who do we want to influence? What are the key behaviors we want to change? How and when do we reach them to be most effective?

Persuasive content

How do we communicate with our patients in a way that motivates them to take responsibility for their personal health, change some behaviors and do all they can to stay healthy? How do we help them want to change? How do we give them the education and skills they need to change? What are the essential ingredients to developing persuasive content? Social and digital media will play a very big role.

Right technology

What technology can we implement to help patients monitor and report their progress?

Engaged patients cost less!

Here is what your leadership needs to know: Engaged patients cost less.

A study in the February issue of Health Affairs looked at the role that patients play in determining health-related outcomes. Researchers found that patients who were more knowledgeable, skilled, and confident about managing their day-to-day health had healthcare costs that were 8% lower in the base year and 21% lower in the next year compared to patients who lacked this type of confidence and skill.

That is huge. One of the main objectives of community management is to reduce growth in overall patient costs, and here’s a study that proves it’s possible.

Learn these skills. Help reduce your overall healthcare costs.

How we help

Hive Strategies gives webinars, presentations and workshops to help hospitals and physician clinics learn the skills they need to thrive during health care reform. Read about our services. Start a conversation. Email us or call us at 503-472-5512.

The case was appealed to the state Supreme Court, which declared that the defendant’s negative review is protected speech because there was no proof that his comments were false or were capable of harming the doctor’s reputation.

Yesterday the defendant, Dennis Laurion, wrote the following comment on this site in response to the blogpost. I’ve found his response compelling enough to  share as a separate blog post today. You’ll read a very personal response to a lengthy litigation.

Comments by defendant Dennis Laurion

“Although the Minnesota Supreme Court ultimately dismissed this lawsuit, this entire experience has been distressing to my family.

“We were initially shocked and blindsided by “jocular” comments made so soon after my father’s stroke by somebody who didn’t know us. We were overwhelmed by my being sued after posting a consumer opinion, and we were shocked by the rapidity with which it happened. It has been the 800 pound gorilla in the room.

“My parents would be 88-year-old witnesses. My mother and wife prefer no discussion, because they don’t want to think about it. Conversation with my father only reminds him of his anger over this situation. My siblings and children don’t often bring it up, because they don’t know how to say anything helpful.

Called an oddball, a liar, a coward, a bully…

“I have been demoralized by three years of being called “Defendant Laurion” in public documents. While being sued for defamation, I have been called a passive aggressive, an oddball, a liar, a coward, a bully, a malicious person, and a zealot family member. I’ve been said to have run a cottage industry vendetta, writing 19 letters, and posting 108 adverse Internet postings in person or through proxies. That’s not correct. In reality, I posted ratings at three consumer rating sites, deleted them, and never rewrote them again.

“The plaintiff’s first contact with me was a letter that said in part that he had the means and motivation to pursue me. The financial impact of being sued three years to date has been burdensome, a game of financial attrition that I haven’t wanted to play. The suit cost me the equivalent of two year’s net income – the same as 48 of my car payments plus 48 of my house payments. My family members had to dip into retirement funds to help me.

“After receipt of a threat letter, I deleted my rate-your-doctor site postings and sent confirmation emails to opposing counsel.

Media and internet responses to news coverage

“Since May of 2010, postings on the Internet by others include newspaper accounts of the lawsuit; readers’ remarks about the newspaper accounts; and blog opinion pieces written by doctors, lawyers, public relations professionals, patient advocates, and information technology experts.

“Dozens of websites by doctors, lawyers, patient advocates, medical students, law schools, consumer advocates, and free speech monitors posted opinions that a doctor or plumber shouldn’t sue the family of a customer for a bad rating. These authors never said they saw my deleted ratings – only the news coverage. Newspaper stories have caused people to call or write me to relate their own medical experiences. I’ve referred them to my lawyers. I’ve also received encouragement from other persons who have been sued over accusations of libel or slander.

Laws about slander and libel

“I’ve learned that laws about slander and libel do not conform to one’s expectations. I’ve read that online complaints are safe “if you stick to the facts.” That’s exactly the wrong advice.

“I did not want to merely post my conclusions. I wanted to stick to my recollection of what I’d heard. I don’t like to read generalities like “I’m upset. He did not treat my father well. He was insensitive. He didn’t spend enough time in my opinion.” However, such generalities are excused as opinion, hyperbole, or angry utterances. If one purports to say what happened, factual recitations can be litigated. The plaintiff must prove the facts are willfully misstated, but the defendant can go broke while waiting through the effort.

“I feel that defamation lawsuits are much too easy for wealthy plaintiffs. If I were to attempt suing a doctor for malpractice, my case would not proceed until I’d obtained an affidavit from another doctor, declaring that the defendant’s actions did not conform to established procedures.”

How we help

Hive Strategies gives webinars, presentations and workshops to help hospitals and physician clinics learn the skills they need to thrive during health care reform. Read about our services. Start a conversation. Email us or call us at 503-472-5512.

Flckr: CSA

MacArthur OB/GYN is an Irving, TX, medical practice that uses Facebook, Twitter, YouTube, 4Square, Pinterest and HealthTap to engage with patients.

Most providers ask, “How can they possibly have time to include all that social media in their practice?”

The six-week post-partum visit: What are my options?

Dr. Jeff Livingston, OB/GYN, answers with a specific example:

When a teenage mom comes in for her six-week post-partum visit, a doctor or midwife’s main goal is to determine a birth control plan. That visit may last only 8-10 minutes.

The doctor asks the question, “What do you want to do for birth control?” If she knows nothing, she will say, “What are my options?” Then the provider spends the next eight minutes describing the options.

Your social media and internet strategy pays off

“But what if you use your social media and internet strategy to educate her about birth control the past nine months?” Livingston asks. “Now, if you say, ‘What do you want to do?’ she’ll tell you, ‘I want to do this.’ Then our eight minutes is not spent listing the options. It’s spent answering detailed, high-end questions.

“My life as a doctor got easier, and the care I provided her got better, because she was engaged.

“We’re doing that with urban, teen, pregnant women. That is not an easy demographic to turn into educated health care consumers. But we do it every day, and we’ve been doing it for years now.”

It starts with the early adopters

So why are doctors so reluctant to embrace social media? “It’s true of any technology,” Livingston explains. “You have early adopters who see the future and then you have the masses who understand it once it’s been proven.

“Most people in life understand the concept of investing a small amount of time in some activity that then allows you to reap the rewards over the long term. Doctors just haven’t made the jump that it applies here.”

Watch for our next blogpost: What is HealthTap, anyway? 

How we help

Hive Strategies gives webinars, presentations and workshops to help hospitals and physician clinics learn the skills they need to thrive during health care reform. Read about our services. Start a conversation. Email us or call us at 503-472-5512.

flickr: StormKatt

You could call Dr. Jeff Livingston, OB/GYN, a social media pioneer.

As I explained in earlier blog posts here and here, the Irving, TX, physician has been using social media to educate and connect with his patients since his teenage daughter suggested he start a My Space page to reach out to high school students struggling with pregnancy and STDs.

I know that many doctors are reluctant to embrace social media for fear of HIPAA violations and negative comments, so I asked him how he responds to those concerns.

Avoiding HIPAA violations in social media is natural

“I don’t think it’s that hard” to avoid HIPAA violations, he says. “If you step out of technology and just think about how doctors communicate throughout the day, they do it very naturally and never think about it.

“When you’re in a doctor’s lounge there’s a certain way of talking. When you get into the lobby you change. And when you get on an elevator you completely change. And you do that very naturally.

“The same thing applies on the internet. It’s a very big elevator with a lot of people on it. What you are already doing naturally can flow to the technology itself.”

Never disclose any kind of private health information

Livingston says the concept is simple. “You can never disclose any kind of private, personal health information. You can’t diagnose. You can’t treat. But you can answer general questions. You can be helpful. You can provide lots of health information. You can provide guidance. Just don’t diagnose and treat patients.”

A couple of years ago a patient posted a question on the practice Facebook page. “Is it okay to go swimming while you’re pregnant?

There is a safe way to respond: “Unless instructed by your doctor, there’s no reason why a pregnant woman can’t enjoy a swimming pool. Water is relaxing, it will take pressure off your back and it will cool you off in a hot Texas sun.”

Or there is the illegal way: “Because you have difficult labors and an abnormal placenta, it’s not a good idea for you to swim.”

How do you respond to negative comments?

“To be honest, it doesn’t happen that much for us,” says Livingston. “I’m not going to engage in controversial discussions on Twitter or post controversial things on Facebook. We really haven’t had people put negative stuff on our Facebook page.

“I actually don’t totally understand why this is true, but I can tell you from years now of doing it, it is true. Most patients inherently understand how social networks work and behave incredibly appropriately,” he explains.

“I have never had someone send me a tweet that said ‘I think I’m in labor.’ I have never had someone put on our Facebook page, ‘I think my water broke.’ People who use these networks understand the public nature and act appropriately.”

Coming next:

What is HealthTap, and why will it be the next big social media tool for physicians?

How we help

Hive Strategies gives webinars, presentations and workshops to help hospitals and physician clinics learn the skills they need to thrive during health care reform. Read about our services. Start a conversation. Email us or call us at 503-472-5512.

flckr: woodleywonderworks

Dr. Jeff Livingston, OB/GYN, is hooked on social media.

As I explained in a previous blogpost, Livingston jumped onto My Space when his teenager daughter told him that would help him reach out to teenagers facing pregnancy and STDs, and he never looked back.

Why? Because, he says, “social media makes your life easier and the care you provide better.”

How? It has to do with the long life of online information. Here’s how Livingston explains it:

Americans want to engage online about their health

Studies show that “Americans in general want to engage online about their health, but they’re recognizing that what they’re finding may not be real, or validated or actionable.

“It’s real important that doctors get involved in getting good content online,” continues Livingston. “That might be writing a blog once a week, creating short YouTube video clips or it might be creating more dynamic content on your website and promoting your website as the first place to get information.

Good health content connects you outside the office

“If I’m providing good health content online that’s available and accessible to my patients, in a lot of ways we’re still connecting outside the office. Even though I did work at an earlier time, that work is still there.

“If I write a nice summary about a birth control method or surgical procedure, that patient is still interacting with me and the way I talk and the way I explain things. That’s available outside of our time in the room. And that has a lot of value.

“I can invest a small amount of time now and benefit a large number of patients over time.”

What do you see when you Google your name or practice?

Livingston says that he often finds that doctors are very surprised at what they see when they Google their name or Google their practice.

“Whether or not you choose to get involved in social media, you still have a digital footprint. You still have an online reputation, but now it’s getting created about you and for you without you having any say in the matter. When you engage online you are creating your own online reputation and your own digital footprint.”

The importance of adding value

“The key to successful social media is adding value,” says Livingston. “Think about a company Facebook page you like – maybe your favorite TV show.

“They tell you something extra about the character,” Livingston points out. “Or they provide an extra two minutes of footage from the show, or something interesting about the actor who plays the character. They’re adding value. They’re not just saying watch our show.

“Just like people do with non-healthcare things they enjoy, they interact with health care hospitals and clinics that bring them value and they tune out the ones who market to them.”

Coming next:

• People get it: Why you shouldn’t worry much about negative comments and HIPAA violations.
• What is HealthTap, and why will it be the next big social media tool for physicians?

How we help

Hive Strategies gives webinars, presentations and workshops to help hospitals and physician clinics learn the skills they need to thrive during health care reform. Read about our services. Start a conversation. Email us or call us at 503-472-5512.

“I was trying to address the problem of teen pregnancy in our area,” he remembers. “There were a lot of pregnancies and sexually transmitted diseases. I was volunteering time at the local high school.”

“I came home one night, and my teenage daughter said, ‘Dad, you ought to get a My Space page.’” Livingston had no idea what that was, so he asked his daughter to help create the page for him. The next time he spoke to a group of high school students he put the page address on the screen. “The page went crazy,” he says. “Teenagers started asking all sorts of health questions about private things.”

Hooked on social media

Livingston was hooked on social media. “I’m trying to connect with these young people. They communicate one way, and I’m doing it in a traditional, old-fashioned way. If your audience is over there, you need to go over there.”

Today MacArthur OB/GYN is blogging and active on Facebook, Twitter, 4Square, Pinterest, YouTube and HealthTap.

“We have tried to always stay on the edge,” explains Livingston. “We just try to evolve.”

Physicians should take the social media lead

Although today Katie Barton doubles as the clinic’s IHER specialist and social media coordinator, she views that mostly as a coordination role. Livingston thinks it’s very important that physicians take the lead role in social media.

“Some doctors make the mistake of approaching social media as a marketing tool for the practice,” he says. “I always caution and advise against that. Use the internet and social media to help patients engage and learn more about their health. Nobody’s better at doing that than the doctor himself.

“The practice development will come naturally and accidentally because your voice will be real and authentic,” he counsels. “And your patients will appreciate it.” And that will lead to practice growth.

Some simple advice

Livingston’s first advice for doctors is simple.

• Start small.
• Pick one social media platform.
• Do it yourself.
• Do it well.
• The practice growth will follow.

“I don’t think there’s one answer for all,” explains Livingston. “Once you get a feel for how sites work, then you can diversify where you put time and energy.

Different tools for different specialties

For instance, if you’re a dermatologist or plastic surgeon, YouTube or Pinterest will be natural networks, since they provide such visual illustrations of what you do. OB/GYNs and pediatricians are looking to build long-term relationships, so Facebook and blogging are ideal. But if you’re a general or orthopedic surgeon, you want to showcase your expertise and help patients understand acute problems. For that, YouTube is a perfect fit.

“Divide and conquer,” advises Livingston. “Pick out different talents in the group. Maybe one doctor’s a great writer. She’ll be responsible for blog content. And look for technology to make things easier.”

In the end, Livingston emphasizes, “social media makes your life easier and the care you provide better.”

Coming up:

• Why physicians must use social media to correct misinformation online.
• People get it: Why you shouldn’t worry much about negative comments and HIPAA violations.
• What is HealthTap, and why will it be the next big social media tool for physicians?

How we help

Hive Strategies gives webinars, presentations and workshops to help hospitals and physician clinics learn the skills they need to thrive during health care reform. Read about our services. Start a conversation. Email us or call us at 503-472-5512.

flickr: GollyGforce

A four year legal battle over a patient’s right to make negative comments about a doctor in social media ended last week when the Minnesota Supreme Court ruled unanimously that the comment was protected speech. We covered the case in an earlier blogpost.

The battle started when Dr. David McKee sued Dennis Laurion for calling him “a real tool” on physician rating sites after McKee treated Laurion’s father poorly during a hospital stay. “Referring to someone as ‘a real tool’ falls into the category of pure opinion because the term ‘real tool’ cannot be reasonably interpreted as stating a fact and it cannot be proven true or false,” wrote the court.

Laurion, who was forced to deplete his savings and borrow from relatives to pay for his defense, was not surprisingly relieved.

The shocker, though, was the response of McKee. According to the Star Tribune, McKee is now ticked off at the people who posted hundreds more negative comments about him after the story went viral. Incredulously, the story reports that McKee “hasn’t ruled out a second lawsuit stemming from these posts.”

Yes, you read that right. After spending “at least $50,000 in legal fees and another $11,000 to clear his name online after the story went viral” McKee is considering suing the rest of the people who, exercising their right of protected speech, chimed in.

I’m speechless.

How we help

Hive Strategies gives webinars, presentations and workshops to help hospitals and physician clinics learn the skills they need to thrive during health care reform. Read about our services. Start a conversation. Email us or call us at 503-472-5512.

The New York Daily News headline read “Fury sparked as ob-gyn posts personal patient info on Facebook.” Ironically, my final presentation was titled: “Managing Risk: Safely Navigating the Waters of HIPAA and Negative Comments in Social Media.”  A new case study had emerged.

What exactly caused the fury?

May I show up late to her delivery?

Dr. Amy Dunbar, 33, of St. John’s Mercy Medical Center in St. Louis, Mo., was irritated by a perennially late patient and posted the following on her personal Facebook page:

“So I have a patient who has chosen to either no-show or be late (sometimes hours) for all of her prenatal visits, ultrasounds and NSTs. She is now 3 hours late for her induction. May I show up late to her delivery?”

It may have ended there, except that a woman named Amanda Johnson took a screenshot of Dunbar’s status, and posted the image to Mercy Moms To Be, a Facebook group run by Dr. Dunbar’s hospital, Mercy Medical Center.

Comments flowed on Mercy Moms’ page, with some demanding the hospital fire or otherwise discipline Dunbar, while others jumped to the doctor’s defense.

Did the post violate HIPAA?

Although insensitive, did Dr. Dunbar’s post rise to the level of violating HIPAA regulations. Did she deserve to be terminated? The hospital decided the answer was no. In a statement emailed to Mashable, Mercy Medical Center wrote:

“Mercy values the dignity and privacy of all our patients and we are very sorry that this incident occurred. While our privacy compliance staff has confirmed that this physician’s comments did not represent a breach of privacy laws, they were inappropriate and not in line with our values of respect and dignity. Mercy holds its physicians and other co-workers to high standards in ensuring the protection of patient information. We cannot comment on specific disciplinary actions, but we will use this as an opportunity to reinforce our standards through additional education of our physicians and co-workers, including appropriate use of social media.”

The opposite argument could be made. Dr. Dunbar revealed that it was a patient scheduled to be induced that day, and in a follow-up comment said the patient had suffered a stillborn birth earlier. Certainly family and friends who knew the patient well would be able to identify her. Is that enough?

Kudos to the administrator of the fan page

I offer kudos to the administrator of the Mercy Moms to Be fan page. I’m sure the hospital did not expect this kind of controversy on a page dedicated to new and expectant parents. But rather than remove comments, they let the healthy conversation flow, adding credibility and authenticity to the site.

The lasting lesson here: Doctors, be careful what you post, whether it be personal or public, on the internet. I’m sure it’s a lesson Dr. Dunbar will not soon forget.

How we help

Hive Strategies gives webinars, presentations and workshops to help hospitals and physician clinics learn the skills they need to thrive during health care reform. Read about our services. Start a conversation. Email us or call us at 503-472-5512.

Thanks to a great client, Lisa Miller, CNM, JD, and Jim Goodrich, executive director of Symposia Medicus, for helping to make this happen. And thanks to the 140 providers who will attend the conference who have motivated me to sharpen my thinking as I’ve developed presentations on the critical role social media can play for OB/GYN health care professionals.

I have long felt that expecting and new moms comprise one of the most natural of all healthcare communities, and this conference is a perfect time to help these providers understand the amazing opportunities available to them.

The first session, titled Best Practices: How Hospitals & Clinics are Using Social Media to Create Loyal Patients & Build Successful Practices, outlines seven best practices that lead to success.

Count the costs

Before you begin any social media effort, make sure you are aware of the resources in costs, time and energy. Many physicians are lured to social media with the prospect that social media is “free.” Nothing could be further from the truth. Although setting up a Facebook account is free, the time and energy spent to successfully build a Facebook community is a significant investment.

Establish clear objectives

Before you do anything, identify clear objectives and develop a strategy to accomplish them.

It’s not about you – it’s about your patients

Don’t make the mistake of making your social media efforts all about you. Every blog, every Facebook post, every tweet, every YouTube video should start by asking the question “Do my patients really care about this.”

Start small and grow gradually

Don’t mistake numbers of followers for engagement. The most vibrant social media communities start wit a few followers/likers, create as much engagement as possible, and grow gradually – always keeping in mind that engagement is the key, not numbers.

Share interesting, useful information

This is how you keep your patients coming back to your blogs and Facebook pages for more. Dr. Natasha Burgert, a Kansas City, MO, pediatrician who uses social media in her practice, has an interesting yardstick: Whenever she gets the question three times from different patients, she blogs about it.

Stay the course

Successful communities don’t grow overnight. Earlier you established clear objectives. Remember what those are, and continue to do the things necessary to accomplish them, a step at a time. Social media is a drip-drip-drip strategy, not a flood.

Evaluate your success

Regularly evaluate how you’re doing and make adjustments as necessary. Some things work better than others, and it’s okay to adapt to changing realities.

These seven steps can help health care providers build vibrant communities that make a difference in the lives of their patients.

How we help

Hive Strategies gives webinars, presentations and workshops to help hospitals and physician clinics learn the skills they need to thrive during health care reform. Read about our services. Start a conversation. Email us or call us at 503-472-5512.

Today The Joint Commission releases its “Improving America’s Hospitals” annual report, including its first ever list of the nation’s top performers on key quality measures.

This recognition is based on data reported about evidence-based clinical processes that are shown to improve care for certain conditions, including heart attack, heart failure, pneumonia, surgical care and children’s asthma.

If your hospital is one of the fortunate 405 hospitals in America receiving this recognition, it’s a great opportunity to distinguish yourself from your competition.

Traditional communication tools

In the past, you would have prepared a news release and sent it to your local media, sat back and crossed your fingers in the hopes that an editor would find the information newsworthy. Then you may have created a paid advertisement for newspaper, radio, billboard or even television, trumpeting the good news.

But if you are one of the 1,000 U.S. hospitals that has embraced social media, you have a whole new arsenal of tools to spread the word. Here are some of the other things you can do to get the word out to your social media followers and friends.

Develop a patient-centered news release

In your news release, resist the tendency to talk about how great this news is for your hospital. Make sure that early in your release you explain in simple terms the benefit to your patients and their families. As Chris Bevolo has so well stated, Jane (or Joe) Public doesn’t care about your hospital. She cares about herself and her family. How does this recognition make her safer and healthier when she comes to your hospital?

Make sure your news release has links to The Joint Commission, your hospital’s website and other supporting materials.

Post the release to your website

Google search (and Bing and Yahoo search for that matter) loves fresh web content, and a “newsroom” or “latest news” section on your website is an easy way to develop new content. When you include links to The Joint Commission’s website and the full report, you add credibility to your news and additional search interest.

In addition, the news is there for a long time for patients and their families to find when they browse your site.

Mention the recognition in your hospital blog

Only about 85 U.S. hospitals who embrace social media are consistently blogging, according to Ed Bennett’s hospital social media list. That’s unfortunate. I understand that regular blogging seems daunting to many, but it’s proven to be one of the best ways to build long-term loyalty and interest from your community. If you’re one of the fortunate hospitals to have loyal followers of a hospital blog, here’s your chance to put a personal touch to the recognition.

Tweet your recognition

Tweet the good news to your followers with a link to your news release on your website. If news media pick up the story, tweet again with a link to media stories.

Post the news on your Facebook page

Announce the good news on your Facebook page. You have more room on Facebook to explain in greater detail the value of this recognition to your patients. Remember to include a link to the news release on your website and a link to your YouTube video.

Develop a simple video for your website and YouTube channel

This is your opportunity to add a visual element to your social media. Create a simple video using a handheld Flip or iPhone camera. It doesn’t need to be fancy. Just make sure the lighting is good, the image is steady and the sound is clear.

Post the video to your YouTube channel, tag it with the essential key words and link back to your website.

Studies show that patients want to hear from clinical experts, not PR folks. So don’t feature your marketing director. Instead, focus on your quality control manager or a physician or nurse who specializes in the area of your recognition (heart attack, heart failure, pneumonia, surgical care or children’s asthma).

And remember to make sure that his or her comments focus on the patient, not the hospital. How does this recognition show that patients are safer and healthier by coming to your hospital?

The payoff

When you implement social media platforms, you take the message to patients and families who care about your hospital. They’ve shown it by following your Twitter feed or liking your hospital.

And when they share the good news with their friends and their friends share it with their friends, you’re benefitting by the exponential reach of social media. This is when all the hard work you’ve put into building your social media community pays off.

Congratulations!

How we help

Hive Strategies gives webinars, presentations and workshops to help hospitals and physician clinics learn the skills they need to thrive during health care reform. Read about our services. Start a conversation. Email us or call us at 503-472-5512.