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Big Pharma And Social Media: How To Avoid Trouble With The FDA


Pharmaceutical companies can use social media to engage and educate patients as well as to provide reliable information about their products. But how do companies tap social media without running afoul of the Food and Drug Administration (FDA) and various regulatory requirements? To find out, I asked Colleen Tracy James. James is a partner in Mayer Brown’s New York office, where she is a member of the firm’s Intellectual Property practice and Life Sciences group.

Belbey: What are the challenges facing pharmaceutical firms when using social media?

James: The internet is the Wild Wild West. We are still figuring out how to maneuver and make sure information is reliable and trustworthy. This is especially important when it comes to pharmaceutical products because it impacts our health and well-being. Pharmaceutical companies face a lot of challenges on social media, such as how to handle incomplete and misinformation about their products. We all remember the famous Kim Kardashian Instagram post where she touted the benefit of a drug that treats morning sickness, but she did not disclose any of the side effects. According to the FDA Guidance, when you use social media, you need to include the ‘good, bad and the ugly' about your product. Your social media posts need to be fair and balanced.

Belbey: How can pharmaceutical companies control the message and the information?

James: One way to control the message is to create what the industry calls a “controlled environment” such as creating a company webpage for a drug or disease. In this way, firms can make sure information is accurate and complete. That keeps them in line with the FDA regulations. That’s very different from third party information, where the company does not have control over how its product are discussed.


Belbey: Can firms use controlled environments and social media to correct misinformation?

James: Yes. If patients are talking to each other and sharing a misconception of your product, you may want to, as a company, respond to that. You may decide to allow certain employees in the corporation to engage with potential consumers on social media and to answer questions. Or you could provide a chat room as part of your own platform. In that case, your obligation to correct misinformation may be heightened because now you have control of that website.

Belbey: How can pharmaceutical firms use Twitter?

James: Twitter is one of the areas where we’ve seen some specific guidance from the FDA. Due to its character limitations, the FDA is concerned that if you don’t have enough space, you can’t provide a fair and balanced (benefits and downsides) view of your drug. Pharmaceutical companies face serious penalties by the FDA if they don’t make the proper disclosures --  something that pharmaceutical companies want to avoid. If you are responsible for disseminating misinformation about your drug, and the wrong person takes it because he or she wasn’t aware of the contraindications or the side effects, the pharmaceutical companies open themselves up for liability. In short, pharmaceutical companies must be careful not to mislead consumers on Twitter.


Belbey: Given that there are real risks associated with not complying with advertising rules and regulations, how should firms move forward safely?

James: Pharmaceutical firms should develop clear and decisive social media advertising policies. First, they need to figure out which platforms they will use, how they will control their messages, whether they’re going to allow chat rooms, and how to manage comments from patients who want a dialog. If interactivity is permitted, companies need to clearly define which employees may interact with consumers, patients and doctors on social media. The firm also needs a content strategy, so that responses are in compliance with what the FDA has approved the pharmaceutical company may say about their product. You also may need a team of legal advisers to confirm that content about your product is okay to put on social media. Pharmaceutical companies must be careful that employees don’t provide people with wrong information when responding on social media. For example, you can’t say, “This medication is for a headache but you can also take it for something else that’s not a headache.” That would be a violation, historically speaking, as firms are not allowed to market their drugs’ off-label uses or mention off-label uses. And finally, I also suggest that companies have a compliance officer tasked with making sure there’s a policy in place and it’s being complied with and updated with evolving FDA guidance.

Since the FDA was created, we’ve gone from radio to TV and to now social media. Just like the past when industry adapted to new forms of communications, pharmaceutical companies are now figuring out how to advertise and communicate using the latest media within the regulatory framework.

Contributor’s notes: For more information, read “5 Social Media Pitfalls In The Pharmaceutical Industry” by Henniger Bullock and Colleen Tracy James, Mayer Brown LLP.

Here is guidance from the FDA pertaining to advertising and social media for your convenience:

Medical Product Communications That Are Consistent With the FDA-Required Labeling — Questions and Answers (Draft Jan 2017)

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Social media and people with HIV. Results from an Italian survey


As it is evident from the literature, the use of Internet, particularly Web 2.0 in healthcare, is now under debate. Mainly, in Italy there is a shortage of spe…
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Examining Physician Use of Social Media in 2017


In 2016, a Pew Research Center survey found that two-thirds of people worldwide used the Internet.1 With its broad reach and diversity of users and content producers, the Internet offers unique opportunities for individuals to inform, connect, and collaborate across the globe.

As technology has made social media more accessible, the popularity of online social interaction has grown. For example, a recent survey found that 68% of all adults in the U.S. are Facebook users.2

Global social networks and special interest forums have become gathering places for individuals from all walks of life to share and discuss ideas.

How are physicians using the Internet and social media in 2017?

Exact numbers vary, but most studies indicate that Internet usage by physicians now exceeds 80%.3 Physicians use social media for personal interactions as well as professional communication and research.

Social media usage by participants falls into three broad content categories: Creation, curation, and consumption. The breakdown of that usage follows a 1-9-90 pattern.

Approximately 1% of healthcare professionals using social media are content producers, creating and publishing original content. These physicians are creating blogs, forums, and information-sharing websites that provide information to ePatients and other healthcare professionals.

Another 9% engage with others on social media by commenting on posts and participating in group discussions or online chats. Content curation activities include identifying and sharing useful information or links with followers or other members of an online community.

Finally, 90% of physicians are social media consumers. These individuals use the Internet and social media to find and read relevant information related to their patients and practice.

Using online resources, physicians can access medical news and updates, clinical and diagnostic tools, drug databases, patient information, and more.4

How can physicians further leverage social media to communicate and interact with patients and peers?

Physicians can join the social media conversation by sharing useful information with their social network.

Using tools such as Twitter’s hashtag ontology makes it easy for physicians, researchers, and patients to find relevant content and discussions. These hashtags allow web users to locate content by category and tag their own relevant content so that it can be located by others.

Other methods of participating include joining disease- or condition-specific online forums or Facebook groups and answering questions on platforms such as Quora. Participation in online Twitter chats or Facebook Live streaming presentations allow physicians to interact in real time with peers and the public.

Physicians can also become content producers, creating original content to share with the broader Internet community.

What are the benefits of having a social media presence for physicians?

Social media provides a fertile ground for physicians who seek new learning and networking opportunities. Physicians can access millions of scientific journal articles using online portals.5 Webinars and video streaming provide further access to a growing global knowledge base.

Additionally, many physicians report that peer-to-peer interaction is one of the greatest benefits of social media. Physicians participating in social media exchanges report that they learn about evidence-based research and discuss new medical guidelines using Twitter and other social media platforms.6

When medical professionals share and discuss information from these resources, their knowledge base, and that of their peers, grows.

Being online also creates new avenues for physicians to network and gain name recognition. Author Dr. Stiegler notes that physicians in academia can bolster recognition of their work and name by making social media connections.

Physicians in search of speaking or teaching opportunities can use social media to connect with and demonstrate their knowledge to decision makers.

Finally, maintaining an active social media presence creates an online biography of sorts. Managing one’s online reputation is essential as patients now turn to the Internet for information before choosing a doctor.

What are some of the reasons physicians give for not using social media?

As the research indicates, most physicians have joined the conversation online at some level. Nonetheless, concerns remain in the healthcare community. Foremost among these concerns are the physician’s ethical and legal obligations.

Because a misstatement on social media can spread quickly through social sharing, some physicians are reluctant to share information or opinions online. They may also avoid statements that appear to provide a diagnosis due to professional ethics standards.7

Additionally, privacy rules loom particularly large as a reason why physicians are cautious about engaging with individual patients.

Supplementing these legal and ethical concerns are issues of logistics. Time is a precious commodity, and online interaction requires a time commitment.

Writing skills are also a concern for some physicians.8 While very knowledgeable in their fields, many physicians have no formal training in expository writing. These physicians may feel uncomfortable creating and sharing original content.

The Future of Social Media for Physicians and Patients

After weighing the benefits of increased social media engagement against the risks, more physicians are deciding to log on and connect.

With an increased use of digital medical records, personal virtual assistants, and wearable devices, we expect to see new and innovative ways for physicians and patients to interact through social media in the years to come. As this growth continues, new platforms and apps will develop to facilitate interactions and help more physicians become active social media participants.


1. Pew Research Center, Smartphone Ownership and Usage Continues to Climb in Emerging Economies, February 22, 2016.

2. Pew Research Center, Social Media Update 2016, November 11, 2016.

3. referralMD, 30 Amazing Mobile Health Technology Statistics for Today’s Physician, 2017; See also, 2015 HIMSS Mobile Technology Survey, April 2015.

4. referralMD, 30 Amazing Mobile Health Technology Statistics for Today’s Physician, 2017.

5. Paul Hitlin, Health issues topped the list of scientific studies reaching wide audience in 2016, December 28, 2016.

6. Lauren Campbell, Yolanda Evans, Megan Pumper, and Megan A. Moreno, Social Media Use by Physicians’ Qualitative Study, July 2016.

7. MMS Physicians’ Guide to Social Media, March 2016.

8. Lauren Campbell, Yolanda Evans, Megan Pumper and Megan A. Moreno, Social Media Use by Physicians’ Qualitative Study, July 2016.

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Clinical Insights from Social Media Data: Amplifying Patient Voice with Symplur


What data from social media can help healthcare organizations?

One of the biggest challenges of online and social data is the sheer volume of unstructured data. Can your physician read all your tweets and postings? Hopefully not. Physicians have data and work overload, a daily report of steps taken from activity trackers or online social media use hurts their ability to treat patients. HealthIT solutions can help process this data and find patterns and changes.

I had a conversation with Audun Utengen about actionable insights into healthcare from his company, Symplur. At Datapalooza he participated in a panel and mentioned the rich amount of patient data that can be found on twitter (shocked gasp followed by a furrowed brow). Symplur signals tracks online engagement.  You can find healthcare insights from conversations really quickly. They provide tools that help healthcare providers get patient insights where they are naturally interacting. There is value in meeting patients where they are, and patients are discussing their healthcare online.

Originally, the assumption was that patients would not say things online. Sensitive topics do not naturally show up in social media use- fewer people are discussing gonorrhea online than receive treatment for gonorrhea. Providers assumed that things which are protected patient information would not show up on twitter. They were wrong. As most social media users know- it’s shocking what people will post online. Not every aspect of health is on twitter but patients want to engage online.  They go to twitter because they want their voices to be heard. They want things to change. They can’t be ignored on twitter. They want their voices to be heard by people in decision-making positions.

Patient’s online discussion have positive impacts on organizations. The key is to be proactive about patient engagement online. Stanford did a study looking about patients’ engagement at conferences. Typically, you will find 1 patient in the top 1 percent of influencers. While this number is low, conferences which have a higher percentage of patients active as top influencers have a greater reach. Want to increase your Healthcare voice and conference audience? Engage patient advocates online. Engaging patients is commercially valuable in amplification. Future patients get more insight as well.  Audun Utengen and I looked at the data from Datapalooza and found that 11 of the top 100 influencers were patients.  That is way ahead of the median number for all healthcare conferences- in 2016 the average number of top influencers that were patients at a conference was one.

“They did a great job giving patients a voice at the conference. I am impressed.”

-Audun Utengen, Co-Founder of Symplur



Healthcare Stakeholder breakdown of the top 100 influencers ranked by the Healthcare Social Graph Score.


Datapalooza had a higher than average reach and a unique blend of participants. Audun Utengen described some of the unique features of the conference:

“The social conversation from the conference was very dynamic. From the 9,366 tweets, 80% included at least one mention. Lot’s of connections were made and we witnessed the typical “flattening of healthcare” that social media is known for by breaking down the barriers between the stakeholder groups. Below is a network analysis graph showing the flattening and the conversational patterns between Twitter account and their healthcare stakeholder groupings.”

Conversations blend between different stakeholders in the healthcare conversation at Datapalooza

The ability for many stakeholders to access information and interact with each other in one place is one of the advantages of twitter. Using hashtags can help stakeholders learn about content about a specific topic quickly. One of the things Symplur is allows is the visualization of keywords surrounding conversations on twitter. When looking at the conversations from Datapalooza the topic of “patients” was very high. Unsurprisingly, “data” is the topic of focus. Patient, Health and Patients rounded out the top conversation topics.

Keyword Frequency Analysis Graph

Symplur Signals have been used for over 200 healthcare studies. They partner with academic research centers seeking more information from online conversations. Companies can also look at competitors in their area and see how they compare. Does a nearby provider have more positive mentions on social media?

Data from online interactions can also give insights into patient health. Social usage has unique implications for mental health. Frequently, online behavior change can predict mental health change. Pediatricians and Providers are in a position to see online behavior in their area and help families understand the implications. If bullying is a problem in your area providers can know their patients will have higher stress levels and provide resources and support. Certain behaviors and even emojis indicate a higher risk of depression. A suicide that will predictably happen based on social data will not show up in clinical records. Listening to what patients want us to hear will help provide greater support.

The sheer volume of social data can mask its usefulness. Online activity and data can be difficult to process for many clinicians. In a world of ever-increasing data and patients reporting everything from steps taken a day to now online behavior many providers have data overload. Data insight tools such as Symplur filter data into a format that allows physicians and systems to use it to improve patient outcomes.

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Les réseaux sociaux moyen de communication pour les pros de santé


Les réseaux sociaux sont un moyen de communication pour les professionnels de santé et une volonté d’informer leurs patients.
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Digital Opinion Influencers/Leaders: A Disruptive Trend in Physician Marketing?


Pharma firms have long recognized the power of key opinion leaders (KOLs) in driving influence through traditional channels: journals, speaking events and word of mouth. The problem, however, is that healthcare providers (HCPs) and patients are acquiring information about disease and treatment in the online world – and many KOLs are not “digital opinion influencers,” or DOIs. This creates an opportunity – strategic DOI identification, outreach and management – for brand, communications and medical teams that is often overlooked or poorly addressed.


Digital opinion influencers are influential members of a health community turned to for advice, opinions and information. Their influence flows from reach (followers), their resonance (content sharing) and relevance (topics discussed). Their distinguishing characteristic (versus traditional KOLs) is their use of social media to either create or amplify messages. DOIs are both medical professionals and non-professionals.


Based on our analyses for a range of pharma clients, we have found that DOIs and KOLs often exist in largely different universes, with little overlap. Typically, fewer than 20 percent of KOLs will also have a social media presence and just a handful will rank alongside DOIs in terms of online reach. In the patient world, this is to be expected as many DOIs are individuals as opposed to patient advocacy groups that would already be on a pharmaceutical company’s radar.

Pharma Engagements with Patients and Doctors at ASCO


The stakeholder group in healthcare that has been the most reluctant to adopt and to engage on social media is arguably pharma. Cultural and regulatory con
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6 Legal Issues When Healthcare Gets Social 


In the healthcare world, today’s patients demand greater flexibility, convenience and cost transparency when they access health care. This has changed the face of communications for the healthcare industry. Patients are increasingly turning to online sources and social media for information-related health issues. In fact, a recent global survey revealed that 29% of health industry respondents believe that social media for external communication, collaboration, and commerce is currently of the highest strategic importance to their organization.

However, as the healthcare industry seeks to drive down costs, there are 6 legal risks can arise when healthcare providers use social media and other new forms of communications:

  1. Patient Privacy – HIPAA and state privacy laws limit healthcare providers’ ability to interact with patients through social media and other forms of communications. HIPAA and state privacy laws prohibit healthcare providers from disclosing patient information without proper patient authorization. Information protected by HIPAA includes anything that can be used to identify a patient, including pictures. A healthcare provider discloses patient information without patient authorization in violation of HIPAA and/or state privacy laws can be subject in fines and other penalties.
  2. Litigation & eDiscovery – Healthcare providers and insurers are vulnerable to lawsuits from a wide variety of sources, from consumers, regulatory bodies and even employees, all of which translate into high cost and risks. One of the challenges of litigation is the growing complexities of litigation preparedness, especially around information management.
  3. Under the Federal Rules of Civil Procedure, the parties involved in a lawsuit are required to make good faith efforts to produce all information, written or electronic, requested by the opposing party. Failure to do so would result in expensive fines, the loss of the lawsuit and negative publicity
  4. Fraud and Abuse – Federal and state laws aimed at preventing fraud and abuse in health care prohibit healthcare providers from giving third parties anything of value as an inducement for the third party to generate referrals to the healthcare provider for services which may be reimbursable by Medicare or Medicaid. Paying third parties to use social media to talk up a healthcare provider’s services may present risks under laws aimed at preventing fraud and abuse, such as the federal Medicare and the Medicaid Patient Protection Act of 1987 (“Antikickback Statute”).
  5. Tax-Exempt Status – Healthcare providers that are exempt from taxation under Section 501(c)(3) of the Internal Revenue Code are prohibited from intervening in political campaigns and from seeking to influence legislation as a substantial part of their activities. This restriction may extend to advertising on or sponsoring social media or other public sites that support a political candidate or particular pieces of legislation.
  6. Physician Licensing – Healthcare professionals need to be careful about providing medical advice to patients using social media. If a patient receiving the medical advice from a doctor through social media is located in a state in which the doctor is not licensed, the doctor giving the advice risks liability under state licensing laws.
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Five Reasons Why Physicians Need to Use Social Media


Physician participation in social media is a health care imperative according to Dr. Kevin Pho, a practicing internist and the founder, a leading online health portal; however, many physicians remain skeptical about the value of social media.  At an Ethics Forum hosted by the Massachusetts Medical Society on December 2, 2011, Pho suggested several reasons why physicians need to embrace new ways to communicate with their patients.

A social media epiphany

Pho began blogging in May, 2004 as a way to share links to health care resources and talk about health care reform.  In the fall of 2004, when the Merck drug Vioxx was recalled, Pho’s office was flooded with patient phone calls.  In response, Pho decided to write a blog post about the recall.  When one of his patients mentioned that the blog post had reassured and comforted him, Pho recognized the tremendous potential of social media.    He realized that patients want health information but are overwhelmed, frustrated, confused and even frightened by what they find online.  Health care professionals, Pho noted, can play an important role by becoming a reputable source of online information or by directing patients to reliable sources.  

Making the case for social media participation

Pho offered five reasons doctors should participate in social media:

  1. Provide context.  Pho pointed out that every day new health stories are published.  Social media is a powerful way for physicians to provide context and meaning to the news items that patients read and view.
  2. Dispel myths.  Online health information can be medically and factually inaccurate.  To maintain physicians’ standing as health care authorities, Pho emphasized that it is critical for doctors to use social media to counter myths perpetuated by inaccurate health information.
  3. Influence the health care debate.  Pho cited the results of a Gallup survey which concluded that patients trust physicians regarding health care policy. Participation in social media gives physicians a way to express their views and influence the formulation of policies that will shape how medicine is practiced.
  4. Choose social networks carefully. There are many different social media networks today. Facebook has been the most popular for a long time, but others are gaining traction too, such as Instagram. It’s a good idea to buy Instagram likes and invest in other social networks, since they are changing the marketing landscape for the healthcare profession.
  5. Connect with mainstream media.  Experience with social media can provide physicians with the skills they need to connect with mainstream media.  For example, Pho noted that writing his blog gave him the confidence to write op-eds for mainstream news publications.
  6. Hear what patients have to say.  Social media gives patients a place to express their frustrations and concerns about health care.  By listening to patient feedback on his blog, Pho has changed the way he practices medicine.  He now offers same day appointments, doesn’t take his laptop into the exam room and makes sure patients receive their test results.

Rules of engagement

Prior to using social media, Pho suggested that physicians consult guidelines, such as those prepared by the American Medical Association or the Massachusetts Medical Society.    He emphasized that patient privacy always comes first.  He also offered these pointers:

  1. Tiptoe into social media.  Start small by establishing a presence in a single social media community.   Expand your presence as you get more comfortable.
  2. Stay professional.  Pho advised that rules for online and offline professional behavior are identical:  behavior on the web is no different from behavior in the exam room.
  3. Think twice before you hit enter.  Pho reminded attendees that what you post on the web is permanently indexed by search engines so post thoughtfully not impulsively. 
  4. Manage your online reputation.  According to Pho you can’t get delete a negative online review but you can downplay its significance by creating a healthy online presence.  He noted that any page you put in your own name such as websites, blogs or social profiles on Linkedin, Twitter or Facebook, will rank more highly in search results than reviews on third party rating sites.  Additionally, he suggested being proactive by asking patients to submit reviews. He noted that most reviews are positive.  He also encourages doctors to Google their name at least once a week to continually monitor and protect their reputations.

 Pho closed by noting that the true value of social media for physicians may be its ability to strengthen and preserve relationships with patients.

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#Top 10 Pharma: Twitter Engagement Index - Listly


Oltre i follower .... l'Engagement Index.
It is calculated by a statistical analysis on engagement, reach, demographics, network and othe
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The role of social media in cancer care - Oncology Central


To mark our focus on social media in cancer care we recently spoke with Deanna Attai from the University of California (CA, USA) about the potential use of social media in cancer care including how oncologists can incorporate social media into their care plans as well as the opportunities and risks they should be aware of
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How Cleveland Clinic connects with patients via social media


Cleveland Clinic has about two million followers on Facebook and 900,000 on Twitter, and is also active on Pinterest and Instagram.

At many hospitals patient engagement—a popular industry term for how providers and patients can work together to improve an individual’s health—means using social media to promote the facility’s physicians, areas of specialization and what’s new at the hospital, says Cleveland Clinic director Amanda Todorovich.

But at the Cleveland Clinic, one of the most active users of social media among healthcare providers, patient engagement means using blogs, Facebook, Twitter and other channels to provide content that matters in a patient’s daily life, Todorovich says.

The Cleveland Clinic is a multispecialty academic hospital located in Cleveland, Ohio, that is owned and operated by the Cleveland Clinic Foundation, an Ohio nonprofit corporation established in 1921. In addition to the flagship hospital in Cleveland, Cleveland Clinic also operates affiliated facilities in Florida, Nevada, Canada and the United Arab Emirates.

The Cleveland Clinic also has a substantial base on social media. The health system has been on Facebook and Twitter since 2008 and now has about two million followers on Facebook and 900,000 on Twitter. Cleveland Clinic also publishes Health Essentials, one of the most widely read hospital blogs online. In just three years the number of consumers and patients that have signed up for Health Essentials has gone from just a handful to more than five million readers, Todorovich says

Cleveland Clinic updates the blog up to nine times daily on a range of topics including brain and spine health, cancer care, cold and flu, digestive, health ear, nose and throat, family medicine, heart and vascular health, lung health, pregnancy and childbirth, sports and overall fitness and wellness.

Cleveland Clinic, which has expanded the number of marketing department writers, editors and developers from three dedicated employees to 25 in three years, also sends out up to 18 daily tweets on a wide variety of topics such as “does your cut need a stitch” and “picking the best and worst sweeteners.”

By making social media a cornerstone of its digital, mobile and patient engagement strategy, Cleveland Clinic is out to show patients—and the broader healthcare industry—that Facebook, Twitter and other channels are more than just tools for achieving such basic marketing goal as building brand awareness, Todorovich says.

“What many hospitals do today with social media is to turn their Facebook page into a scrapbook that’s all about their doctors, what they treat or what’s new around the hospital,” she says. “That approach just tells consumers they are sick, and patients don’t like being told on social media they are sick.”

Consumers may use social networks such as Facebook and Twitter multiple times daily, and for some consumers Facebook is their primary way to stay connected to family and friends, Todorovich says. But most consumers don’t go to a hospital or health system’s Facebook page daily.

“They go there (a hospital Facebook page) when they have a need, and even when they do they don’t want to be reminded they are sick,” she says. “A hospital Facebook page that just serves up passive or ‘here’s all about us’ content can actually be a big turnoff to followers”

Cleveland Clinic takes what Todorovich calls a “pretty aggressive” approach to all forms of social media. For example on its Facebook page, the Cleveland Clinic now does one to two interactive chats each week with a Cleveland Clinic doctor or specialist on a chosen topic, allowing its Facebook followers to ask questions and receive a answer. Some chats attract as many as 3,000 participants.

The Cleveland Clinic also has been active on Pinterest and Instagram since 2014. Over time Cleveland Clinic has created more than 150 infographics on various topics ranging from “the color of pee” and “13 curious questions about your bones” to “how to break your sugar addiction” and “the power of fish in your diet.”

The infographics are an engaging way to present health and wellness content to the clinic’s 13,400 Pinterest followers, Todorovich says.

On Instagram, Cleveland has posted nearly 700 pieces of content for its more than 19,000 followers on various health and wellness topics. “It’s a good social media channel to tell a story,” she says.


The clinic’s marketing and social media staff take a measured approach to putting up social media content, to ensure it resonates with patients and consumers, Todorovich says. For example about 40 physicians write an article for the Health Essentials blog each month, but each topic is screened by Cleveland Clinic’s social media editors for its appeal and relevance before the doctor writes a blog post, Todor0vich says

The social media department also tests content prior to going live on Facebook or another channel by using a predictive analytics program from Atomic Reach to give each piece of a content a score on relevancy to a particular audience.

“We are big on numbers and analysis,” she says.

Most pieces of content also are updated and reedited for various social media outlets so the clinic can get the widest exposure possible. Going forward Cleveland also is opening up ways to make money with its content, she says. The Cleveland Clinic is working with Dotdash—the former that consists of a network of content websites that publish articles and videos about various subjects—to develop policies and programs to help monetize some social media content.

Cleveland Clinic won’t say how much it spends on its various forms of social media content. And revenue from any sponsored or content associated with an advertising program is still minimal, the clinic says. But adding a revenue-generating strategy to its ongoing social media program is one way “we keep pushing farther out,” Todorovich says.

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Social Media Etiquette for Healthcare Professionals


Presentation at Department of Ophthalmology conference, The Medical City 3 May 2017.
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The need for pharmacists to draw boundaries on social media


Social media is omnipresent today. Be it in private life or at work, every action and decision can be instantly projected to millions of people worldwide. As with all technological advancements, the omnipresence of social media is potentially a double-edged sword.

In the age where social media is powerful enough to influence the presidency candidature of a country, how should pharmacists draw the line that separates professionalism with the freedom to express their thoughts?

How well connected are Malaysians?

According to the 2016 report by the Malaysian Digital Association, close to 70% of Malaysians have access to the internet. Within the "online" population, almost all of them use social media as one of their communication tools. On average, Malaysians spend 5.1 hours a day on the internet, where 2.8 hours of the time is spent on social networks.

To put this into perspective, collectively Malaysians spend a staggering 21 billion hours on social media annually. Unsurprisingly, pharmacists and other healthcare professionals are increasing their reliance on digital platforms to communicate and interact with their patients and peers.

Social media and pharmacy

The utilisation of social media to exchange information is a contemporary method that presents unique challenges, especially to pharmacists in upholding professional conducts that are deemed appropriate.

A recent study conducted by researchers from the University of Sydney in Australia looked at how pharmacists use social media in their daily practice. The team reported that the respondents, mostly community pharmacists, limited their online interactions on social media.

Although most of the pharmacies own a Facebook page, the pharmacist owners did not “friend” consumers on their page in order to maintain a clear “boundary between professional and personal relationship”. Nonetheless, the respondents also saw the need to correct misleading information that was widely circulated on social media. Some innovative pharmacists used short YouTube videos to augment patient counselling in the pharmacy.

The grey areas

Concerns over patients’ privacy and confidentiality should take precedence when exploring social media as an alternative communication channel. There is still yet a suitable protection mechanism that can ensure information shared on these platforms will not be exploited by a third party, where the data could be used against either the patient or the pharmacist.

Secondly, there is a lack of evidence to support the notion that communication through social media is both effective and accurate. Text messages and written paragraphs or essays are the most commonly used media to convey health questions and relevant answers.

Without sufficient contact with patients, pharmacists will have a tough time to correctly assess their conditions, let alone provide accurate clinical advice to them.

Malaysian MOH guidelines

In order to address the increasing use of social media among healthcare professionals for clinical consultations, the Malaysian Ministry of Health issued a guideline to the healthcare professionals (HCP) working in public health facilities. The guideline particularly focuses on consultation between HCPs.

From the 8-page long guideline, the MOH stressed the importance of maintaining patients' confidentiality. HCPs are urged not to share images or videos that contain any patient identifiers, such as names, hospital registration number or their home address. Written consent should be sought from the patients before HCPs are allowed to upload any material relating to them.

The MOH also outlined the criteria of a "good social media platform that can be approved and used for group consultation". Features such as traceable member profiles, the presence of a moderator and sufficient security to exclude public access to the data are suggested. The guideline goes further to prohibit the use of several popular social media for consultation purposes. The banned platforms include Facebook, Twitter, Instagram and YouTube. MIMS

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Is social media right for pharma?


KEY TAKEAWAY: GWI Social examined the very latest figures for social media engagement, social behaviors and trends within the social space.  Among the key findings…filling up spare time is the main reason for using social media among 16-24s, while older groups see these platforms as a way to keep up with friends and the news.  But is social media right for pharma?

Almost every internet user can now be reached via social media – 94% of digital consumers aged 16-64 say they have an account on at least one social platform and 98% have visited/used one within the last month.  So then, is social media a channel for pharma to reach patients?

Pfizer is using Facebook as an ad platform, but are men really going to click on the ad because Viagra now comes in individual dosage envelopes?

Facebook has become a media rich RSS feed with users following interests and participating in social media activism via the share button.  We can easily express outrage by simply sharing content we agree with but as facebook seems to know where we have been on the web and what we have done will “suggested post” health content become too intrusive?

In research, earlier this year, a lot of older facebook users were surprised to have suggested content appear in their facebook feed.  A number of older women said they were offended and shocked that facebook seemed to know what health content they were researching online.

So is social media right for pharma?  In some cases, yes.  At a minimum pharma should be listening to what patients are saying about their product as well as competitors’ products and using the input for content that addresses questions/concerns.

As for advertising on social media there are opportunities, but rather than advertise “single packs” perhaps Pfizer would do better to talk about men’s health as a way to engage the social media audience.

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Panorama des médias sociaux 2017


Déjà la dixième édition de mon panorama des médias sociaux. Quand j’ai publié la première version en 2008, je ne me doutais pas que ces plateformes sociales allaient s’emparer du web et…
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Why Social Media Should Matter to Pharma Marketers


loicpharma's curator insight, April 18, 6:21 AM
L'importance des médias sociaux chez les responsables marketing dans l'industrie pharmaceutique

Successful doctors will find meaningful ways to use social media to engage patients and colleagues


Look me up. I’m on Twitter (@MattDynamic). This isn’t particularly remarkable. In fact, there are 313 million other active Twitter users. But for me, it is remarkable and a major departure from my past behavior.

As a resident, I am bombarded by messages about the dangers of Twitter and, more broadly, social media. I have sat through many HIPAA and human resource meetings with dire warnings to not post anything pertaining to patient care online. We are counseled, that the best course of action is to avoid social media altogether.  If we choose not to do this, we are told to maximizing privacy settings, not using our real names, and avoid social media contact with patients. I am a naturally private person, so this has always resonated with me. I have made every effort to leave no digital footprints. But what if this isn’t the best solution for physicians and our patients?

I recently attended the annual meeting of the Society for Gastrointestinal and Endoscopic Surgeons (SAGES). I had the privilege of sitting through an excellent talk by author and speaker Dave Kerpen (@DaveKerpen) on being “likable.” Misunderstanding what he meant by likable, I anticipated another talk on how surgeons’ egos and attitudes impede patient care.  Instead, he talked about engaging patients and colleagues through a wide variety of means, one of the most significant being social media.  I was struck by all the ways that doctors are interacting with each other and with patients through social media and all the potential to improve these interactions in the future.  More significantly, however, I was impressed that this is a revolution that is going to happen with or without us.



Public evaluations and ratings are already a reality, whether we realize it or not. These sources are likely to play a major role in physician selection and reimbursement in the near future.  Some of these evaluations will be formal, such as outcome measurements which will be publicly available.  But many of them will be far less formal.  Healthgrades and a number of other websites already allow patients to rate their doctors on a large number of highly subjective criteria.  It will soon be impossible to avoid having a social media presence.  In response to this, we need to shift our focus towards maintaining and managing our social media presence.

Even maintaining online resources, however, will soon be insufficient. The most successful and influential surgeons in the years to come, will find meaningful ways to use social media to reach and engage patients and colleagues. These new tools should not be feared.  Like a newly developed medication with great potential, they should be adopted and adapted to meet the needs of providers and patients.  While they have the potential for great harm, they also hold great promise. A physician who fails to adopt new technology and new procedures in the wards or operating room quickly becomes out of date, and the same will be true with our engagement of social media.


We are already seeing this revolution at many academic medical centers.  Physicians who are leaders in their fields are posting articles and opinions on Twitter, producing podcasts, and maintaining Facebook groups.  But far too few of us, especially in the community setting, are listening and even fewer are joining in to create richer and more meaningful content.

I still don’t fully understand hashtags, and I’m struggling to figure out how to find friends on Yelp (I signed up for that one too), but I have come to realize that we are headed towards a future where we will increasingly interact with peers and patients through social media. And I want to help shape that future. So follow me on Twitter, message me on Facebook, label me a colleague on Doximity, or connect with me on LinkedIn. I’ll be on all of them, looking for ways to help my profession and my patients.

Matt Dull is a surgery resident. 

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Best social media healthcare campaigns we can all learn from - Daniels Healthcare


Daniels share some of the best healthcare campaigns they've seen lately, which show how using social media can yield great results.
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Does Social Media Influence Millennials' Healthcare Decisions?


There’s no point in denying that millennials are influenced by opinions posted on social media. But does the influence of social media expand to include health care decisions?
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What Can You Do To Convert Online Health Seekers Into New Patients?


“What can be the best way to convert a health seeker into new patients? This is really an important question for all the cosmetic surgery hospitals or clinics. Surely, the answer of this question will be cosmetic surgery marketing.”.


There are lot of clinics are available in every place. All are willing to provide the best services. in this case, wise patients like to choose the best option for the treatment.


What do they do initially?

    • 1. A well-planned research: For a marketing professional, the study of the behavior of a patient can be a first step in making a marketing plan. Today’s patients are educated enough to conduct a detailed research before they decide to choose a health clinic.

    • 2. Offline Vs Online: In this research, both of the offline and online ways are used, but according to a fresh marketing research, the greater percentage of the patients conducts an online research for the treatment.
      As some of the offline ways, the patients look for the information in the newspapers and magazines, they talk to their friends or relative. Sometimes they try to interview an old patients or sometimes. They personally visit the clinic to have some initial meetings with the doctors.
    • 3. Effective Online Tools: Modern patients are equipped with various online tools for conducting health research. This fact can be very crucial for the cosmetic surgery marketing campaign. The professionals who do digital marketing for the plastic surgeons can target the patients who are present online for the health research.

      Some of the main online ways the patients use are given below:
    •    a.) Search engines: According to the experts, more than 85% of the patients conduct a research before they reach a final decision and more than 75% of the patients use a search engine like Google, Yahoo, Bing etc.
    •    b.) Websites of the clinics: A lot of patients directly go to the website of the clinic to find relevant information about the cosmetic surgeons, treatment procedures, cost of the treatments, and other offers etc.
    •    c.) Blogs: A number of patients check some blogs if it is possible to find some blog made by a cosmetic surgeon. With the help of the blog, the patients try to check the quality and validity of the surgeon.
    •    d.) Social media As a general observation, more than 20% of conversations on social websites are about a health-related issue. It means social media is playing a vital role in connecting the patient facing different health issues. It means social media pages made by hospitals or clinics can be a great tool for the digital marketing for plastic surgeons.
    •    e.) Local listing websites: To know about all the local cosmetic clinics, many of the patients look in the local listings of the cosmetic surgeons as most of the patients like to have the treatment in a nearby clinic.

    • 4. What can be a Better Plan for Cosmetic Surgery SEO? As we see, most of the patients are present online for seeking for health related information. All the cosmetic surgeons can attract them by making a powerful digital marketing plan. The plan may include the following steps:
    • Hiring a Digital Marketing Agency: Hire a digital marketing agency can be a crucial step for enhancing the marketing strategy and attracting more customers. A digital marketing agency applies all the modern techniques that are the best to utilize the online presence of the health seekers.
    • Build a powerful website: You can develop a website that is full of valid information. Making a powerful presence with enhancing the quality of the services is the best approach for the cosmetic surgery marketing campaign.
    • Start to manage a blog: Blogging is a new age tool for telling the customers about the services provided by the clinic. Most probably, the visitors of the website check the blog when they arrive at the website. it means, having a blog and updating it regularly can be very effective for cosmetic surgery marketing. A blog can be a part of the website and you can also make a separate blog to attract more patients.
    • Local presence is important:

      This is very crucial to be a part of one or more local listing websites. A clinic in the same city is always preferred by the patients. Therefore, if you are not present in the list, you may miss many patients.
      Developing an online presence is important but more important thing is doing whatever you have claimed. The patients like to deal with trusted, reliable and authentic cosmetic surgeons. All of the digital marketing ideas work when they are applied with high-quality services.
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Use of Social Media to Recruit Participants in Clinical Trials Raises Ethical Concerns


n the recent issue of the American Journal of Bioethics, the target article addresses the ethics of finding participants for clinical trials on social media sites. The authors, from Harvard Law School and Harvard Medical School, analyzed the particular ethical issues that occur in the online setting compared to in-person recruitment and provide practical recommendations for investigators and Institutional Review Boards (IRBs).


"Recruitment to clinical trials is extremely challenging, raising distinctively practical and ethical issues, and social media is beginning to show real promise as a recruitment tool, due largely to its ubiquity and use among just about every demographic," Professor Luke Gelinas of Harvard Law School told He says that there has been little serious reflection on the ethical and regulatory issues raised by recruitment using social media. He also thinks that recruiting via social media risks being under-utilized.

"Our working group wanted to address the ethical issues toward the end of providing some concrete guidance to IRBs and investigators, which can hopefully facilitate the review and use of social media as a recruitment mechanism."

Today online communities provide virtual support groups for people with certain diseases and for their friends and family making virtual groups a good place to find potential research participants. Furthermore, social media allows researchers to find participants that have been traditionally hard-to-reach, such as those with rare diseases.

According to Gelinas, "One of the main takeaways from our article is that recruiting online is in many ways similar to more traditional 'off-line' methods of recruitment. You can usually draw analogies between online and off-line scenarios—e.g., comparing approaching a social media support group for cancer to approaching an in-person hospital support group—that can help us get our bearings when evaluating social media recruitment."

In-person recruitment can be divided into two categories: passive and active. Passive recruitment might be posting a flyer in a doctor's office in hopes that a potential participant will contact them. This would be analogous to posting a banner ad on a medical website or an online patient support group.

Active recruitment, on the other hand, would involve emailing a particular patient in an online support group based on the person's online activity. This would be analogous to approaching a particular patient in a clinic based on the doctor's knowledge of his or her condition. With these two distinctions in mind, ethical guidelines can be laid out for online recruitment.

Where possible, the rules for active and passive recruitment offline, also apply to the online platform. Gelinas et al. suggest first identifying an analogous offline situation to the social media technique being proposed. In this way investigators and IRBs can identify the most pertinent ethical considerations in the offline situation and use them as a guide to the ethics of the online situation. Then, they can identify ways that the online version differs from the offline version.

In-person or offline ethical norms prioritize beneficence, respect for persons, and justice. These foundational norms can therefore be translated to the online world. However, the online platform is distinctive in that it provides more interconnectedness and embedded personal information than offline interactions do. Because of this, the authors contend that every online interaction must address respecting the privacy and respecting the other interests of social media users. Additionally, they discuss the importance of investigator transparency in online interactions.

Respect for privacy can be a tricky thing when it comes to social media and other online platforms. For one, people may share personal information that, if they knew it would be used for research purposes, they may not share. Additionally, many people are unaware of online security risks and end up sharing information that is more easily accessible than they thought. Investigators are encouraged to seek permission to use personal information even if the information has technically been published online. Furthermore, investigators should not share personal information even if it has been shared online.

Transparency, which would fall under respect for persons, requires investigators to be up-front with who they are and the nature of their research online. Specifically when recruiting, investigators should be honest in describing the aims, details, risks, and benefits of their study. In many cases, investigators may need to contact the site moderator to obtain permission to recruit from their group. Additionally, investigators should not create fake online identities or pose as a participant of the group.

One issue that is specific to the online platform in regards to transparency is whether investigators are required to let people know that they are collecting data. Depending on the nature of the research study, investigators could reasonably obtain information just by "lurking" on the group page. The authors contend that the obligation for an investigator to disclose that he is collecting data is related to how public the particular social media group is. If the group is a closed-group in which only members can view comments, then this would likely mean the investigator should disclose that he is doing a study.

Another issues specific to online recruiting is tapping into someone else's network to find potential research participants. A participant's network will likely have people who have similar demographics, experiences, or qualities to the research participant. However tapping into the research participant's network risks disclosing the participant's eligibility for a particular clinical trial. Therefore, this must be done in such a way that protects the privacy of the participant.

Finally, there is a risk that people will discuss a clinical trial online. Unlike in-person trials where participants may not come in contact with each other, they possibly could interact online, especially if they are from the same support group or network. This may skew the results of the trial.

Clinical trials are an important part of medical research, but as many as 60% of clinical trials are delayed or cancelled because researchers cannot find enough research participants. Turning to online platforms increases the number of people that an investigator can reach, which in turn, results in more participants available for a study.

"While some IRBs have explicit policies in place for social media recruitment, many do not, and there is a sense, as in other areas, that the technology is outpacing the ethics," Gelinas says. "For IRBs who have the bandwidth, developing written policies and holding educational sessions on social media can be extremely helpful in getting members up to speed, and we hope that our work can be useful in this effort."

The use of social media as a recruitment tool for research with humans is increasing, and likely to continue to grow. Despite this, to date there has been no specific regulatory guidance and there has been little in the bioethics literature to guide investigators and institutional review boards (IRBs) faced with navigating the ethical issues such use raises. We begin to fill this gap by first defending a nonexceptionalist methodology for assessing social media recruitment; second, examining respect for privacy and investigator transparency as key norms governing social media recruitment; and, finally, analyzing three relatively novel aspects of social media recruitment: (i) the ethical significance of compliance with website "terms of use"; (ii) the ethics of recruiting from the online networks of research participants; and (iii) the ethical implications of online communication from and between participants. Two checklists aimed at guiding investigators and IRBs through the ethical issues are included as appendices.

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Social media for patients: benefits and drawbacks. 



Social media is increasingly utilized by patients to educate themselves on a disease process and to find hospital, physicians, and physician networks most capable of treating their condition. However, little is known about quality of the content of the multiple online platforms patients have to communicate with other potential patients and their potential benefits and drawbacks.


Patients are not passive consumers of health information anymore but are playing an active role in the delivery of health services through an online environment. The control and the regulation of the sources of information are very difficult. The overall quality of the information was poor. Bad or misleading information can be detrimental for patients as well as influence their confidence on physicians and their mutual relationship. Orthopedic surgeons and hospital networks must be aware of these online patient portals as they provide important feedback on the patient opinion and experience that can have a major impact on future patient volume, patient opinion, and perceived quality of care.

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Managing Online Physician Reviews


You know you’ve been there.  You want to find a new doctor or you’ve already selected a new doctor and you are seeing them for the first time. What do you do?  You Google! Before we go any further, let me first suggest that you become a discerning Googler when it comes to healthcare.

Many times, I end up having to dig deeper to page 2 or 3 or 4 on an online search to find substantial, credible information, and that’s crazy. Having to dig to page 3 or 4 to find the credible health information we seek is insane and poses a real problem for physicians and healthcare practices.

Today I’m passing along a great podcast for those interested in healthcare social media.  The podcast, “Doctor’s Reviews are In,” from Amazon #1 Best Selling Author, Daniel Lemin, tackles an interesting aspect of social media: online physician reviews.  Mr. Lemin sat down with Dr. Kevin Pho, the premier expert and leading physician voice for all things healthcare social media. If you haven’t checked out his comprehensive encyclopedia of a blog, you must.  He publishes four times a day.  Wow.

Inevitably, behemoth sites such as and come up first in any physician related online search. On these two sites, there is currently no requirement and no way to verify if a patient who writes a review has actually been seen by the physician they have reviewed. Healthgrades mentions they verify the person posting is not a spammer by “going through several validation steps,” such as confirming a reviewer’s email address. There is no mention of ability to confirm the patient actually saw the physician. I could not find an FAQ section on vitals.  I looked for a few minutes.  Either it’s not there or it is buried in some section of the website that is difficult to find, rendering it the same as not existing.

There is at least one online review company that offers verified reviews. ZocDoc offers a number of pretty cool tools: ability to schedule appointments online, to store redundant, painful check-in paperwork, and to review physicians you have seen. Their website is pretty slick, and easy on the eyes.

So what’s a physician to do?  Rely on word of mouth?  Ignore fake reviews?  Continue to be incognito online?  No!  Today it is more important than ever for physicians to be proactive about building their online reputation.  Dr. Pho eloquently points out that the practicing physician voice is almost totally missing from the online world. In addition, he stated that when a review is legitimate, studies suggest that most reviews are, in fact, positive!

Having to dig to page 3 or 4 in a Google search to find the credible health information you seek is insane and poses a real problem for physicians and healthcare practices.

I like Dr. Pho’s recommendations to offset and manage a physician’s online reputation.  Dr. Pho suggests taking a proactive, positive and creative approach to managing online reputations in healthcare.

  1. Bring your ratings system in house.  Bringing this feature “in-house” provides more control for a physician practice. The way I see it, there’s a number of ways to do this.  One, form a relationship with a service like ZocDoc so that you ensure reviews are legitimate and ranked well in online searches. Two, have patients write testimonials that are mailed in to your practice and put online.  Option two is probably not viable for most practices given the over paperworked, metric driven healthcare system that we exist in. Three, get an iPad for your practice so that patients can do a review at check out in the waiting room. Your IT guy can upload them to your website as featured testimonials.  Sure, it’s not a “usual” thing to do, and without a doubt, someone in the practice will complain that it’s too cumbersome or causes them too much extra work. However, I would argue losing business to a poor online brand and fake reviews is a worse idea. For the right practice that has a champion to own this process and is committed to improving their online brand, this could actually be a very easy thing to do.
  2. At a minimum, set up a LinkedIn profile.  Come on, docs!  This one is so easy.  It takes less than 20 minutes to set up a bare bones LinkedIn profile. Setting up a LinkedIn profile creates an online resume, provides you a public image online and lends you the power of LinkedIn’s search engine optimization.  Having the power of LinkedIn’s SEO is important, given that the unverified review sites have excellent SEO and often outrank physician’s own websites when their name is googled. Don’t have the time to make your profile or want to be trained on how to manage your social profiles?  Contact me.  It’s painless.  I promise.
  3. Consider joining HCP only social media sites like Doximity and SERMO.  Again, creating a Doximity or SERMO profile puts some powerful SEO behind your name, and connects you with a vast HCP network. Currently 500,000 physicians are members of Doximity.  Doximity also has a neat feature that allows HCPs to send and receive secure, HIPAA compliant faxes right from a mobile device. SERMO is the largest, global HCP-only social networking site with over 600,000 physician members.  It features such benefits as medical crowdsourcing for complex cases and confidential real world healthcare discussions.

There was so much fantastic information covered in the podcast.  I suggest taking a listen for yourself. The podcast is available on, here. View my recommendations for additional ideas to start building an online brand in my previous post, “A lesson in personal branding: hiding online is no longer an option.

Taking a proactive approach to managing online reputation in healthcare will increasingly become important as patient satisfaction scores are already starting to drive reimbursement from payers.  Furthermore, patients are demanding a better service experience from their healthcare providers as healthcare costs are now frequently pushed down to the patient in the form of higher co-pays/co-insurance, consumer driven healthcare plans with high deductibles, and rising chronic disease epidemics. Dr. Pho points out that healthcare tends to lag a few years behind the newest trends.  Now that most of us can’t even eat at a restaurant without “Yelping” it first, I think it is safe to say, we are almost there with healthcare. I for one, am excited to see what the “Yelp” of healthcare will be!

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