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Addressing Health-Related Misinformation on Social Media #esante #hcsmeufr #digitalhealth #socmed cc @giomarsi


The ubiquitous social media landscape has created an information ecosystem populated by a cacophony of opinion, true and false information, and an unprecedented quantity of data on many topics. Policy makers and the social media industry grapple with the challenge of curbing fake news, disinformation, and hate speech; and the field of medicine is similarly confronted with the spread of false, inaccurate, or incomplete health information.1

From the discourse on the latest tobacco products, alcohol, and alternative therapies to skepticism about medical guidelines, misinformation on social media can have adverse effects on public health. For example, the social media rumors circulating during the Ebola outbreak in 2014 created hostility toward health workers, posing challenges to efforts to control the epidemic.2 Another example is the increasingly prevalent antivaccine social media posts that seemingly legitimize debate about vaccine safety and could be contributing to reductions in vaccination rates and increases in vaccine-preventable disease.3

The spread of health-related misinformation is exacerbated by information silos and echo chamber effects. Social media feeds are personally curated and tailored to individual beliefs, partisan bias, and identity. Consequently, information silos are created in which the likelihood for exchange of differing viewpoints decreases, while the risk for amplifying misinformation within a closed network increases. However, research suggests there may be ways to lessen the echo chamber effects by deliberately enabling social learning and engagement of different perspectives.4

Regarding the diffusion of information, mounting evidence suggests that falsehoods spread more easily than truths online.5 Meanwhile, these trends are occurring at a time of low trust in institutions, with a 2016 Gallup report indicating that only 36% of individuals in the United States have adequate confidence in the medical system.6 Although the scientific community generally still enjoys relatively high levels of public trust, 1 in 5 individuals expresses skepticism about scientists.7 These realities make it a priority for medicine to identify and mitigate (when appropriate) health misinformation on social media. This Viewpoint outlines a framework that includes priorities in research, public health, and clinical practice.

Gaps in Understanding the Effect of Health Misinformation

Health misinformation can be defined as a health-related claim of fact that is currently false due to a lack of scientific evidence. This misinformation may be abundant on social media and some evidence has linked the sharing of misinformation with health-related knowledge, attitudes, and beliefs. However, more research and data are needed to evaluate potential links between exposure to misinformation and health behaviors and outcomes.

In addition, there is little information about how to help clinicians respond to patients’ false beliefs or misperceptions. Public health communicators similarly struggle to know whether and how to intervene when a health topic becomes misdirected by discourse characterized by falsehoods that are inconsistent with evidence-based medicine.

Developing a Framework for Research and Practice

Medical, public health, social science, and computer science experts must begin working together via interdisciplinary research to address health misinformation on social media, with a focus on the following themes.

Defining the Prevalence and Trends of Health Misinformation

Millions of users contribute to social media platforms daily, generating a massive archive of data for health communication surveillance. It is important to assess the extent of misinformation related to critical vulnerable topics (ie, those topics for which misinformation is most likely to generate negative health consequences). For instance, vaccination, new tobacco products, and so called miracle cures generate large volumes of misinformation.

Deployment of innovative methods on a broader scale is needed (including natural language processing–assisted data mining, social network analysis, and online experimentation) to track the spread of misinformation. Surveillance endeavors must be nimble and adaptable to capture dynamic data and social media posts containing photos, images, and videos.

Understanding How Health Misinformation Is Shared

Receptivity to health misinformation can vary greatly depending on the motivations of the source of the message (eg, promoting a disinformation campaign, endorsing a conspiracy theory, selling a product) as well as the recipient’s social network, sociocultural identity and values, emotions (particularly fear and anger), levels of trust, and concomitant social media use patterns.

Visible attempts at creating and legitimizing controversies (eg, Russian bots generating a vaccine debate) may foster skepticism and mistrust in certain communities.3 Understanding the context of misinformation exchange (such as the social network in which the message is embedded) and the intrapersonal and interpersonal dynamics involved in the processing of the message can help determine the extent of the problem and suggest appropriate remedies.

Evaluating the Reach and Influence of Misinformation on Health

A key challenge for health and medicine is determining the threshold at which an intervention is needed to ameliorate the negative health consequences of misinformation. Assessing the reach and unique health consequences of a message for specific populations (eg, communities most vulnerable to misinformation) is important to inform when and how to respond.

A range of measurement and methodological approaches such as physiological measurements, real-time behavioral data (eg, ecologic momentary assessment), linkage to medical records, marketing research, and mixed-methods approaches offer promising solutions that can help improve understanding of how individuals evaluate and internalize a message. For example, observational studies (eg, eye tracking, functional magnetic resonance imaging, or cognitive interviews) can help assess how quickly people accept a claim before internalizing it.

Developing and Testing Interventions

It is necessary to determine when and how to intervene. How can clinicians and experts in communication create and sustain public trust in evidence-based health information? How can partnerships among clinicians, trusted social media influencers, and industry leaders be created? Can the public be taught health literacy to help them discern facts from opinions and falsehoods? Importantly, broader investments in health and science literacy and the cultivation of trust in the medical community may create more systemic improvements than attempts to debunk or correct individual pieces of misinformation on social media.

In addition, tangible support for clinicians is necessary as they continue to interact with patients who have been exposed to or have questions about health misinformation from social media. Understanding the underlying causes of patients’ confusion, concern, and mistrust could help clinicians foster patient-centered communication, rather than dismissing patients’ concerns or superficially categorizing them as skeptics.

Research is needed that informs the development of misinformation-related policies for health care organizations. These organizations should be prepared to use their social media presence to disseminate evidence-based information, counter misinformation, and build trust with the communities they serve.

It is also vital for social media platforms to develop and implement mechanisms for vetting and validating the credibility of information on their platforms. Misinformation has the potential to undermine progress in medicine and health care, and it requires a proactive approach for understanding its prevalence and potential influence rather than labeling misinformation as a fad or wishing it away.

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Article Information

Corresponding Author: Wen-Ying Sylvia Chou, PhD, MPH, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Dr, 3E614, Rockville, MD 20892 (

Published Online: November 14, 2018. doi:10.1001/jama.2018.16865

Conflict of Interest Disclosures: None reported.

Disclaimer: The views expressed reflect those of the authors and do not necessarily reflect the official position of the National Cancer Institute.

Additional Contributions: This Viewpoint is a result of extensive discussion with leading health communication experts. We thank Joseph Cappella, PhD (University of Pennsylvania), Anna Gaysynsky, MPH (National Cancer Institute), Bradford Hesse, PhD (National Cancer Institute), Dannielle Kelley, PhD (National Cancer Institute), Jeff Niederdeppe, PhD (Cornell University), Emily Peterson, PhD (National Cancer Institute), and Brian Southwell, PhD (RTI International) for their unpaid insights and contributions.

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Broniatowski  DA, Jamison  AM, Qi  S,  et al.  Weaponized health communication: Twitter bots and Russian trolls amplify the vaccine debate.  Am J Public Health. 2018;108(10):1378-1384. doi:10.2105/AJPH.2018.304567PubMedGoogle ScholarCrossref
Guilbeault  D, Becker  J, Centola  D.  Social learning and partisan bias in the interpretation of climate trends.  Proc Natl Acad Sci U S A. 2018;115(39):9714-9719. doi:10.1073/pnas.1722664115PubMedGoogle ScholarCrossref
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How Facebook and Twitter could be the next disruptive force in clinical trials #esante #hcsmeufr #digitalhealth


Participants in medical research are more empowered than ever to influence the design and outcomes of experiments. Now, researchers are trying to keep up.
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Dépêche Vétérinaire N°1454 : E-réputation Google  #esante #hcsmeufr 


Dans ce cas pratique paru dans la Dépêche Vétérinaire 1454 du 20 au 26 octobre 2018, VOKARE partage l’expérience d’un cabinet vétérinaire qui a décidé de mettre en place une politique de développement de sa réputation Google. La plateforme Vokare propose automatiquement à vos clients satisfaits de partager leur avis sur Internet. Lors de l’inscription, …
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LinkedIn et Twitter : des lieux numériques propices au BtoB  #esante #hcsmeufr 


Les réseaux sociaux LinkedIn et Twitter sont de véritables aubaines pour travailler en B to B. Il y a plus …
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Social media for medical journals operates in 'wild west,' needs more support to succeed  #esante #hcsmeufr #digitalhealth


Much of the published medical research goes unread by the general public and medical community, despite being largely funded by the federal government and private foundations. To reach more people, medical journals have begun using social media to promote new research.

A new Northwestern Medicine study has found social media editors lack established best practices and support from their journals and home institutions, making it difficult for them to successfully promote new research.

In general, the median citation rate for journal articles -- when one paper refers to another paper -- is zero, meaning a lot of new research isn't being read even in the medical community. If utilized correctly, social media could help journals increase awareness of new research, according to the study. But first, social media editors need more resources and support.

"American tax dollars are paying for research the public never hears about," said senior author Dr. Seth Trueger, assistant professor of emergency medicine at Northwestern University Feinberg School of Medicine and a practicing physician at Northwestern Medicine. "I'm optimistic we can get the word out through social media, but we first need to explore and develop tried-and-true methods to distribute this information to the public."

Study authors urge medical journals to define social media editor roles and responsibilities more clearly and provide more resources to social media editors.

The study was published this week in the journal Academic Medicine. It is the first study to examine this specific role of social media editor at medical journals.

Journals may be able to help social media editors to more effectively get the word out and determine which strategies are most effective, study authors said. Doing so will help journals and social media editors better focus their limited resources.

"Many journals have been building social media editor positions, which is great, but as a relatively new niche, our study found journals didn't really know what these people should be doing," Trueger said. "They would tell new editors to 'take this job and do what you can with it.' It's the wild west."

The study also found: (1) monetary support for these roles is lacking; (2) journals use different metrics to measure engagement and success; and (3) there is no consistency in editor responsibilities among journals.

In addition to his role at Northwestern, Trueger previously was the social media editor for the Annals of Emergency Medicine. He is now the digital media editor at JAMA Network Open and said his goal is to "get eyeballs on the science."

Something Trueger has learned in these positions is how impactful social media can be for medical research, if done properly.

"If you have a paper on a Medicare program, you don't just have physicians looking at that research; there are health economists, patient groups and the general public who have an interest in it," Trueger said. "If we can determine which strategies work for online dissemination, a social media editor's success rate for sharing new information to a wide audience can skyrocket."

Medical schools and universities should better incorporate social media engagement with more tangible support, such as academic credit toward promotion and tenure, according to the study.

Given the overall lack of tangible support reported by social media editors in the study, medical journals should consider providing non-physician staff to help manage social media accounts to support editors in their positions, the study suggested.

Twenty-four social media editors from 19 medical journals participated in the study. The study was funded by the Summer Research Program at the Pritzker School of Medicine at the University of Chicago, which is in part funded by the National Institutes of Health.

Story Source:

Materials provided by Northwestern University. Original written by Kristin Samuelson. Note: Content may be edited for style and length.

Journal Reference:

  1. Melany Lopez, Teresa M. Chan, Brent Thoma, Vineet M. Arora, N. Seth Trueger. The Social Media Editor at Medical JournalsAcademic Medicine, 2018; 1 DOI: 10.1097/ACM.0000000000002496
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Social media scheme boosts breast cancer screening uptake  #esante #hcsmeufr #digitalhealth


An NHS project using social media has driven a 13% increase in first time attendances for breast screening in Stoke-on-Trent over four years.

Under the local initiative, information about screening was posted on Facebook community groups, in a bid to reduce anxiety surrounding breast examinations.

NHS Digital said the move empowered women to make appointments and also allowed them to communicate quickly and easily with health practitioners to ask questions about the screening process.

The initiative is part of NHS Digital’s Widening Digital Participation Programme, commissioned by NHS England, which aims to make digital health services and information accessible to everyone.

Across England attendances for breast screening are declining and most recent figures, from 2016-17, show the proportion of eligible women taking up breast screening in dropped to its lowest level in a decade.

According to NHS Digital, in the last financial year 7,938 women in Stoke-on-Trent failed to attend a breast screening appointment, “meaning around 65 cases of potential breast cancer were not detected”.

Through the project, the North Midlands Breast Screening Service promoted their Facebook page on local community groups which their target group - women aged over 50 - regularly visited.

Posts to the Facebook site, which included information such as patients explaining the screening process and videos showing the rooms where it takes place, were designed to encourage women to share them and so spread the message about the importance of screening.

Data on attendances for first time appointments at the North Midlands Breast Screening Service has shown they increased by an average of 12.9% between three-year screening cycles from 2014 to 2018.

“This is a fantastic idea and the community aspect of the group is so powerful that we now have 1,138 followers,” commented Gina Newman, health improvement practitioner at the North Midlands Breast Screening Service.

“We have seen an increase in the number of ladies who have booked and attended their appointments, who might not have done otherwise”.

“The Stoke project is an example of how digital channels can be used to communicate with patients, providing local advice and answer key concern,” said Juliet Bauer, chief digital officer at NHS England.

“This work is part of the NHS’s wider commitment to digitally transform the way we work with all of our patients, improving the information we provide and empowering the public to take charge of their own health and care.”

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Optimizing Social Media Use in Health Care: The Mayo Clinic Social Media Network #esante #hcsmeufr #digitalhealth


In this interview, EP Lab Digest talks with Farris K. Timimi, MD, Medical Director of the Mayo Clinic Social Media Network (MCSMN), and Lee Aase, Director of the MCSMN and Communications Director of Mayo Clinic’s Social and Digital Innovation (SDI) Team, about social media strategies in health care. 

Tell us about your medical background. How did you become involved with the Mayo Clinic Social Media Network (MCSMN)?

I am a cardiologist specializing in heart failure, and through that work have had an interest in patient involvement, such as with creation of our Patient and Family Advisory Committees. On major initiatives and in our basic structure, Mayo Clinic uses an physician/administrator model of shared leadership, with the administrator managing day-to-day operations and the physician leader helping to ensure medical relevance.

When the Mayo Clinic created what is now MCSMN, I was very interested in taking on the role of Medical Director.

What is the purpose of the MCSMN? When and why was it formed?

In 2011, Mayo Clinic created our Center for Social Media, which is now the Mayo Clinic Social Media Network, to help bring the social media revolution to health care. Our first goal was to ensure that Mayo Clinic staff and stakeholders had the guidelines, training, and resources to apply social media tools in support of clinical practice, education, and research. We also saw an opportunity to share globally what we were developing with colleagues, as well as learn alongside them as we navigated issues and concerns with these new technologies.

We see MCSMN as a catalyst to reduce the activation energy required to apply social media in health care organizations. By using our resources, colleagues can advance in their knowledge and capabilities more quickly than they would on their own.

Our association with Mayo Clinic also helps members gain internal buy-in; with these resources, they will be building on an approach and philosophy that has been shown to be safe and effective.

What is the role of social media in healthcare today? Additionally, what is the role of social media in healthcare education, research, and practice?

Social media has had a transformative impact on society as a whole, and health care is no exception. Through platforms such as Facebook, Twitter, YouTube, Instagram, and others, patients and caregivers can share their experiences as well as look for support and answers. They are able to overcome barriers of space and time to connect with others like them, even if they have a rare condition that is not shared by anyone in their immediate geographical area.

The patients were there first, but now medical professionals and organizations are seeing opportunities to listen, serve, and educate using these tools. 

Tell us about the Social for Healthcare Certificate from the Mayo Clinic and Hootsuite. How did this collaboration come about? What does this training program help achieve? 

The Social for Healthcare Certificate from Mayo Clinic and Hootsuite ( provides focused and trustworthy training for busy professionals who want to safely and effectively learn to use social media. We developed this course with Hootsuite because we wanted to keep it up to date, reflecting on the latest changes in social platforms. Hootsuite markets to its clients, while we offer it to MCSMN members.

Because of its modular design and online delivery, participants can choose the elements they find most valuable and that fit their busy schedule, and it’s available on-demand, 24/7.

This course is our front-line training for any Mayo staff interested in using social media for professional purposes.

Physicians obviously could figure out elements of using social media on their own through trial and error, but our goal is to condense what they need to know into brief modules that they can apply to create their own professional presence, and to avoid missteps they otherwise might make.

What is the Social Media Residency? How long is the program, and what topics are covered?

Social Media Residency ( is a one-day program for those interested in developing a social media strategy aligned with their professional or organizational priorities. Some participants are social media managers for hospitals and are developing overall organizational strategies, while others are clinicians or scientists interested in narrower applications. Our online training provides the foundation, and then in Social Media Residency, we go beyond those basics and dig into strategy, providing guidelines for plan development.

In addition, what can you tell us about the Social Media Fellows Program?

The Social Media Fellows program ( is for those who have gone through Social Media Residency, and want guidance in developing and implementing their social media strategic plans. It’s also a way for them to give back by sharing their experiences with the Network.

How many people have completed the Social for Healthcare Certificate, Social Media Residency, and Social Media Fellows Program thus far? Who is best suited to participate in these programs? 

We’ve had more than 2,000 participants in the Social for Healthcare Certificate, and more than 700 in Social Media Residency. The Fellows program is much smaller, as it involves developing a strategic plan and submitting for review.

The Social for Healthcare Certificate is appropriate for anyone in health care, whether in a clinical or research role or in administration, marketing, and communications. It helps those who aren’t familiar with social media to get up-to-speed quickly, and for younger staff who have personal experience in social media, it introduces important elements of professionalism that are necessary in the health care context.

Social Media Residency is mainly for those who are advocates for social media and who are interested in promoting strategic use of these platforms.

Which programs are available online or onsite? What costs are involved with these opportunities?

As mentioned earlier, the Social for Healthcare Certificate is our online, on-demand program. While the retail price for the course is $250, we include it in both Premium Individual and Organizational memberships.

Registration for Social Media Residency is $795, and includes the Social for Healthcare Certificate. Organization members save 25 percent, and also may have the opportunity to host Social Media Residency, which can enable broader participation by their staff.

What the benefits of MCSMN membership? What other opportunities are available? 

In addition to the Social for Healthcare Certificate, premium members of MCSMN have access to a members-only discussion board where they can safely and confidentially get feedback and answers from fellow members. They also have access to our monthly webinars (regularly $95 each) and save 25 percent on any of our in-person events, including our Annual Conference and Social Media Residency.

In addition to Premium Individual membership, we also offer Organization membership at an affordable flat rate, which gives full premium membership to anyone on the organization’s email domain (e.g.,

Tell us more about the upcoming annual conference in November.

Our Annual Conference will take place from November 14-15 in Jacksonville, Florida, with four compelling keynotes and three tracks of case studies and opportunities for networking and expert consultations. We’re also offering Social Media Residency on our Mayo Clinic campus in Jacksonville on November 13, with special bundled registration available.

Who is involved with Mayo Clinic’s Social and Digital Innovation (SDI) Team?

Our Social and Digital Innovation Team is led by my administrative partner, Lee Aase, and includes representatives on our campuses in Florida and Arizona as well as several members in Minnesota. The SDI team maintains Mayo Clinic’s overall social media presence and also consults with Mayo stakeholders interested in professional or specialty accounts. It also provides the foundation for what we offer through MCSMN. (Editor's Note: See interview with Lee Aase in sidebar.)

Why is important for healthcare professionals to engage on social media? Also, what brief tips do you have for healthcare professionals about how to build a digital identity?

Health care professionals at least need to understand the importance of their online reputation, and the role social media presence can play in shaping what people find when they Google your name. Doctors should all claim and complete their profiles on Doximity, and should also consider how presence on Twitter, LinkedIn, YouTube, and other social networks can affect search results.

Beyond that, they should explore how they can use these tools to accomplish their life’s work. These are powerful tools for communication that enable us to have a much bigger impact than we otherwise would. 

At the same time, digital tools used incorrectly can do more damage than analog communications. But just as with other tools, with proper guidelines and training, these can do immense good.

What main social media platforms are doctors currently using?

Twitter and LinkedIn are probably the most important participatory platforms for physicians. 

Using Twitter hashtags related to diseases or scientific meetings enables physicians to participate in niche conversations that interest them, highlight their expertise, and learn more about patients’ experiences.

LinkedIn provides a platform for longer-form writing and sharing in a more professionally-oriented environment.

Presence on both of these can strongly influence online search results for the physician’s name, pushing some of the unreliable rating and review sites down the page.

Why should organizations and individuals utilize the Mayo Clinic Social Media Network?

The recent PBS documentary by Ken Burns, The Mayo Clinic: Faith – Hope – Science (, begins with an African proverb: “If you want to go fast, go alone. If you want to go far, go together.” 

Through the Mayo Clinic Social Media Network, we help our members go both farther and faster. By using our guidelines, templates, and training materials, our members can jumpstart their social media involvement with trusted resources. And by collaborating with like-minded colleagues from around the globe, they can get new ideas and perspectives to help shape their own initiatives.

Is there anything else you’d like to add?

The Mayo Clinic Social Media Network is a modern-day manifestation of our founders’ philosophy and practice. Drs. Will and Charlie Mayo recognized that to provide the best care to every patient, they needed to travel and learn from others, and bring that knowledge back to their rural Minnesota practice. Dr. Will visited 25 countries on five continents at a time when travel was arduous.

They also welcomed physicians to visit and observe them in surgery, and in the period from 1908 to 1918 alone, nearly 3,400 physicians came to Rochester to observe them and become part of what became known as The Surgeons Club.

We see the Mayo Clinic Social Media Network as the health care social media version of what the Mayo brothers did in surgery, and we’re glad that we can connect with colleagues both face-to-face in our in-person events, and on a continuing basis through the MCSMN community.

I would invite anyone who is interested in these resources to contact my administrative partner, Lee Aase. We’d be glad to be of service.

For more information, follow along on Twitter: 




Interview with Lee Aase, Director of the Mayo Clinic Social Media Network (MCSMN) and Communications Director of the Mayo Clinic’s Social and Digital Innovation (SDI) Team

Tell us about your background, and how the MCSMN came about. 

My background is in media relations, and I was the manager of Mayo Clinic’s media relations team when we began dabbling in “new” media with podcasting in 2005. We were early adopters of platforms such as Facebook, Twitter, and YouTube when they started becoming available, because we saw them as ways to directly reach patients instead of only indirectly through traditional media.

The MCSMN arose as our colleagues at other hospitals saw our leadership in adopting these new platforms, and were interested in learning from us how to navigate this space. We developed tools and training for our Mayo staff, and through MCSMN, we make them available to our colleagues everywhere.

What can you tell us about the Mayo Clinic Social and Digital Innovation (SDI) Team? 

Our team represents Mayo Clinic as a whole, with team members on our three campuses in Rochester, Minnesota, Jacksonville, Florida, and Phoenix/Scottsdale, Arizona. We maintain Mayo Clinic’s enterprise-level accounts on the major social platforms ( Facebook, Twitter, LinkedIn, and YouTube) as well as our community and blogging platform. We also consult with stakeholders interested in specialty-focused social accounts and provide training for them, as well as a central management platform for governance of the accounts. 

How can social media help promote health and improve health care?

Social media provides platforms for listening to both patients and consumers as well as physicians and scientists to share knowledge and the latest research. They are experts in the science of various diseases and conditions, and the patients are experts in the day-to-day challenges of coping with those health issues. For example, I have celiac disease and can benefit from videos from Dr. Joseph Murray (, our leading expert on the science of celiac disease. Through social media, I can connect with fellow patients to get recommendations on restaurants with gluten-free menus when I’m traveling. We like to say that patients are experts by experience, and we’ve collaborated with on a series of blog posts ( featuring those patient insights. 

Why should health care professionals and organizations engage on social media? 

People of all ages are increasingly engaging in social media — particularly when they’re looking for information or support when facing a health concern. If health care professionals aren’t engaged, others who are spreading unscientific remedies or positions, such as the anti-vaccine advocates, will be unchallenged in the online space.

It’s also important from a reputation management perspective; by having social media presence, providers and organizations are equipped to share their perspectives and have a vehicle for telling their side of the story.

How do you see the use or the role of social media evolving? 

I think the opportunity to engage in conversation online is an increasing expectation, and that organizations will be finding ways to hold those conversations not only on broader social networks such as Facebook and Twitter, but on their own digital properties as well. 

What are some of your tips to health care organizations for developing a social media strategy?

Social media strategy needs to be an element of business strategy. With few exceptions, every communications or marketing initiative should have a social media component. The first step to social media strategy is developing an understanding of the nature of the social media platforms, the audiences they attract, and their core capabilities. Then, map those to what you are trying to accomplish, whether it relates to building a clinical practice, improving communications efficiency, promoting clinical trials and other research, or recruiting a top-tier workforce.  

Which social media platforms have you found to be most beneficial or effective for doctors to use? What do you consider to be a “balanced social media diet” in 2018?

We recommend that physicians use social media to help with their online reputation management, because these accounts tend to show up high in search results. Our top recommendations include claiming and completing your account on Doximity (, which powers the U.S. News & World Report search engine, as well as creating accounts on LinkedIn and Twitter. Filming and uploading informational videos to YouTube can also introduce you to prospective patients and begin to build empathy.

Any final thoughts? 

Don’t miss the Social for Healthcare Certificate from Mayo Clinic and Hootsuite (, which we created to provide on-demand basic training in social media for health care professionals. It’s what we use as front-line training for our busy Mayo Clinic staff, so they can choose modules that are most helpful to them. For example, a doctor who wants to create a Twitter account can go through that module in 20-30 minutes and feel confident in setting up a professional account, knowing how Twitter works in the health care context. 

This course is available to any of our premium individual Mayo Clinic Social Media Network members, and for a flat fee, we can make this same training available to anyone in an organization. We’re excited that now we can say any employee of our organization can have access to the same social media training that our Mayo Clinic staff depend upon.

For those who want to dig deeper and take a leadership role in social media in their organization, please check out our Social Media Residency (, a one-day course offered a few times each year, as well as our Annual Conference ( taking place November 14-15 in Jacksonville, Florida.

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A new frontier for drug ads: patient 'influencers' on social media #esante #hcsmeufr #digitalhealth


A new industry will link drug makers with "influencers" — patients with devoted followings who might promote their products or share their insights.
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11 Things Health Leaders Need To Know About Social Media & Marketing #hcsmeufr


Of the more than 7 billion people on Earth, the number of mobile phone users is approaching 5 billion devices, while toothbrush ownership is closer to 4 billion. Indicating that both marketing of technology and public health have great disparities, but also that leadership in health care are not executing on their brands, social media or marketing. But in the U.S., hospital identity and health branding are paramount for success in a community. By listening to patients, getting feedback on wants and needs, and creating new incentives to engage individuals, increased revenue, greater trust and improved health might be achieved.

Here are 11 surprising things to keep in mind when health care and hospital leadership plan marketing efforts for 2019:

    1. The brain processes visual data 60,000 times faster than text. Additionally, 90% of information transmitted to the brain is visual. Whether it’s growing your brand identity or improving medication adherence through instructions, visuals are a key to interacting with and empowering patients.
    2. Surprisingly, Grandparents love Twitter so much their presence on the platform doubled last year. They are also replacing young people who are choosing to leave Facebook. Not only does this indicate they are here to stay for some time, but they are a great place to target our aging population who consume a majority of our health care services.


    1. An estimated 31 billion eCoupons will be redeemed in 2019That means almost 60% of U.S. internet users have redeemed digital coupons or codes at least once. With so many new retail clinic and other hospital services that can use coupon-like strategies for patient cost-savings, this is a must in the new year.
    2. Voice search on devices like Alexa, Siri and Google Search already account for 20% of searches . Depending on the product or service in question, voice search via virtual assistant is certain to play an increasing role in consumer purchasing.



Yemen Is A "Living Hell for Children"

  1. In 2017, it was estimated that 62% of emails were opened on a mobile device. Checking email is the top mobile activity among smartphone and tablet users. So be sure those emails are appealing and informative, as they’ll be consumed on the go.
  2. The number of devices connected to the Internet now exceeds the number of humans on earth. This means health companies and hospitals need to be intentional about marketing on multiple platforms and for many different devices.
  3. Social media influences 74% of shoppers final purchase decisions. Further, 90% of consumers indicate that they trust peer recommendations. Therefore, previous patients and reviews like those on Amazon are your greatest allies.
  4. Instagram has 500 million viewers every single day. And 71% of those are millennials. While plastic surgeons and fitness experts have driven the health trends on this platform, there is a significant opportunity to appeal to and educate the under 35 crowd as they begin making life-long health decisions.
  5. More than 78% of U.S. Internet users research products and services online, and every month, there are more than 10.3 billion Google searches. What your top hits say about your product, organization, or providers will influence your bottom line.
  6. Content marketing costs 62% less than traditional marketing, and, per dollar spent generates about 3X as many leads. When creating a marketing strategy for particular service lines, services, or physician groups, think about exactly who needs to see that ad.
  7. 70% of people surveyed claim they would rather learn about a hospital or company through articles or reviews rather than direct advertisements. Therefore, not only are advertising campaigns important, but so are the patient experience testimonies, community reviews, and visual or print articles. It will pay to make sure your company is being written and talked about.

Nicole Fisher is the founder and CEO of HHR Strategies, a health care and human rights-focused advising firm. She is also a senior policy advisor on Capitol Hill and expert on health innovation, economics, technology, and reform - specifically as they impact vulnerable popul...

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Social Medicine: The Effect of Social Media on the Anti-Vaccine Movement


Social media—the use of platforms like Facebook, Twitter, and Instagram to communicate and share content—has made our world feel smaller and more connected. However, these technologies also have made it easier create, consume, and share unverified, anecdotal information posing as facts.

The anti-vaccine movement has proliferated over recent years, in part because of its most vocal proponents using social media to churn out often misleading information.

The Rise of the Anti-Vax Movement

Perhaps one of the most successful public health interventions in history, the advent of vaccines has led to the global eradication of smallpox, the nearly global eradication of polio, and a drastic decrease in the morbidity and mortality associated with other infectious diseases.1 As a result, many parents are unaware of the threats that these infectious diseases posed for previous generations, and as such, may believe that vaccinations are no longer necessary for their children.


Vaccination refusal has increased in the United States in the last decade, and many other countries have also recorded substantial proportions of parents expressing concerns about the safety of vaccines.2 While health officials maintain that routine childhood vaccines are safe and effective, many parents in developed countries still hesitate to have them administered to their children. Worldwide, 13% of parents decide to forgo vaccinating their children, including 17% of parents in the World Health Organization's European region.3

Although access to health care is an important factor influencing vaccine coverage rates, vaccination refusal also directly affects these rates and is a significant contributor to outbreaks of some infectious diseases—particularly in regions where vaccination refusal is geographically clustered and population immunity is compromised.2 This is exemplified in that outbreaks of pertussis and measles are known to spread through populations where rates of vaccination refusal are high.2

Vaccine hesitancy is a decision-making process that is dependent on trust in healthcare providers and mainstream medicine, among other variables. However, through the combination of homophily—a theory that asserts individuals tend to form connections with others who are similar to them in characteristics such as socioeconomic status, values, beliefs, or attitudes—and the convenience of social media, individuals who have anti-vaccine beliefs can consume information that adheres to their system of beliefs and ignore dissenting information.4

Many members of the medical and scientific communities believe that vaccine hesitancy is a major threat to global health, and since 2013, the World Economic Forum has listed digital misinformation among the main threats to our society.4 Social media platforms have created a direct path for users to produce and consume content, reshaping the way people receive information. Anti-vaccination rhetoric has become part of the mainstream dialogue regarding childhood vaccination, and social media is often employed to foster online spaces that strengthen and popularize anti-vaccination theories.

Despite having been disproved multiple times, perhaps the most popular anti-vaccine theory is that the mumps-measles-rubella (MMR) vaccine causes autism. Mandatory vaccination policies only seem to fuel the controversy. A 2014 study5 sought to test the effectiveness of messages designed to reduce vaccine misperceptions and increase MMR vaccination rates. During the study, 1759 parents in the United States age >18 years with children age ­<17 and younger were surveyed. Participants were randomly assigned to a control group or received 1 of 4 interventions:

  • Information from the Centers for Disease Control and Prevention explaining the lack of evidence that MMR causes autism,
  • Textual information from the Vaccine Information Statement about the dangers of the diseases prevented by MMR,
  • Images of children who have diseases prevented by the MMR vaccine, or
  • A dramatic narrative from the CDC about an infant who almost died from measles

None of the interventions increased a parent's desire to vaccinate a child. While disproving claims of an MMR-autism link reduced misconceptions that vaccines cause autism, intent to vaccinate their children was decreased in parents who had the least positive attitudes toward vaccination. In addition, images of sick children increased belief in a vaccine-autism link, while the measles narrative increased beliefs in vaccine side effects.

Conspiracy theories have become endemic among anti-vaccination groups. These sentiments have been compounded in recent years by decreased trust in the institutions that manufacture or distribute vaccines.1

The effect of vaccination refusal on public health is particularly challenging when misinformation is disseminated through social media. Thought influencers in the anti-vaccine movement include doctors, celebrities, community organizers, and “mommy bloggers” who collectively speak to an audience of about 7 million Facebook followers.1 The potential for disseminating harmful health-related information through social media seems to be at an all-time high.

Echo Chambers, Structural Oppression, and Conspiracy Theories

Social media echo chambers—where users only hear and see information that echoes their own beliefs—further energize the anti-vaccine movement. Clusters of users with opposing views rarely interact with one another, leaving little room for constructive debate. A 2017 study4 analyzed the interaction of 2.6 million Facebook users over 7 years and 5 months. This study's authors found that the consumption of content about vaccines is dominated by the echo chamber effect, and polarization increased over the years. Online users selected information adhering to their belief systems, tended to ignore dissenting information, and joined polarized groups that reinforced that shared narrative, according to the study. These segregated communities emerged directly from users' consumption habits, which may explain why social media campaigns that provide accurate information have limited reach.

Vaccine refusal has also been promoted on Twitter. A study2 found that Twitter users who were more often exposed to negative opinions about the safety and value of human papillomavirus(HPV) vaccines were more likely to tweet negative opinions than users who were more often exposed to neutral or positive information. These tweets, which included misinformation, anecdotes, and opinions that may result in vaccine hesitancy or refusal, made up the majority of HPV vaccine-related information exposures for nearly 30% of users that tweeted about HPV vaccines during the study period. In addition, users expressing negative opinions about HPV vaccines were more closely connected to other users expressing the same opinions.

Further, anti-vaccine conversations often center around moral outrage and structural oppression by institutional government and the media, suggesting a strong logic of “conspiracy-style” beliefs and thinking.6 Although anti-vaccination networks on Facebook are global in scope, sub-network activity appears to be “small world”.6 This polarization isn't just limited to conspiracy theories, but all issues perceived as critical by users, including geopolitics and health.4



Overcoming the Anti-Vax Digital Divide

For the pro-vaccine movement, strategies still exist for sharing information effectively. Vaccine hesitancy and refusal are complex social issues that require interventions at the individual, provider, healthcare system, and national levels. There are ways to leverage social media to reinforce positive sentiments about the value of vaccination:

  • Ongoing surveillance of opinions about vaccination on social media can complement surveys and other monitoring methods to improve the reach of and response to public health communication strategies.2
  • To research ways to counter anti-vaccination thinking, public health professionals should understand the content of anti-vaccination echo chambers through passive involvement in those groups.4
  • Delayed vaccination can signal a need for more information, presenting an opportunity to increase education for this group.1

Social media, while fertile ground for activity for anti-vaccine activists, also can provide a platform for understanding the motivations behind vaccine hesitancy and refusal. The casual nature of social media has altered the doctor-patient interaction—and profoundly changed the way information is disseminated. Empowering experts and health officials to participate in discussions on social media about vaccination is critical to bridging the vaccination information gap.

The public's reliance on social media for vital information has and will continue to increase, and its influence on personal decision-making regarding health. The immediacy and informal nature of social media gives thought leaders a marked advantage in communicating with and influencing the public. In an era when more than 2.3 billion people in 232 countries are active on social media,7 the public health community can correct misinformation by establishing its own social media communities and leveraging established channels to provide facts about the safety and value of vaccines.


  1. Stein RA. The golden age of anti-vaccine conspiracies [published online December 5, 2017]. Germs. doi: 10.18683/germs.2017.1122
  2. Dunn AG, Leask J, Zhou X, Mandl KD, Coiera E. Associations Between Exposure to and Expression of Negative Opinions About Human Papillomavirus Vaccines on Social Media: An Observational Study [published online  June 10, 2015]. J Med Internet Res. doi: 10.2196/jmir.4343
  3. Orr D, Baram-Tsabari A. Science and Politics in the Polio Vaccination Debate on Facebook: A Mixed-Methods Approach to Public Engagement in a Science-Based Dialogue [published online March 30, 2018] J Microbiol Biol Educ. doi: 10.1128/jmbe.v19i1.1500
  4. Schmidt AL, Zollo F, Scala A, Betsch C, Quattrociocchi W. Polarization of the vaccination debate on Facebook [published online June 14, 2018]. Vaccine. doi: 10.1016/j.vaccine.2018.05.040
  5. Nyhan B, Reifler J, Richey S, Freed GL. Effective Messages in Vaccine Promotion: A Randomized Trial Pediatrics. 2014;133(4).
  6. Smith N, Graham T. Mapping the anti-vaccination movement on Facebook [published online December 27, 2017]. Information, Communication & Society. doi: 10.1080/1369118X.2017.1418406
  7. Gu Z, Badger P, Su J, Zhang E, Li X, Zhang L. A vaccine crisis in the era of social media[published online August 11, 2017]. Natl Sci Rev. 2017;5(1):8-10 doi: 10.1093/nsr/nwx098
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Une aide préopératoire pour le chirurgien sans précédent #esante #hcsmeufr


DIVA est une plate-forme logicielle qui crée des représentations virtuelles de patients en fonction de leurs images médicales. Cette représentation innovante communique aux chirurgiens de manière précise la configuration spatiale des tumeurs de leurs patients.
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The Impact and Use of Social Media in Pharmacovigilance #socmed


Pharmacovigilance (PV) has evolved and grown more complex over the past 5 to 10 years due to increasing data volumes, evolving regulations, influence of emerging markets and the emerging social media and innovative technological advances. Digital media is now used by biopharmaceutical companies for communication with patients to create awareness about diseases and treatments, clinical trial enrollments and patient support programs. It presents new channels and methods that can enable companies to move away from traditional PV systems and safety reporting methods towards more patient-centric models for reporting, analyzing and monitoring of safety data.

Key Pharmacovigilance Considerations When Using Digital Media

Biopharmaceutical companies operating in the social media space have a responsibility to document and follow-up on any potential adverse event (AE) reports communicated through these forums in compliance with the applicable regulatory guidance. Most of the regulatory guidance and hence PV activities involving social media and internet are primarily focused around screening of social media sites and follow-up of reported safety data. Additional specific guidance is required to confirm validity of safety data obtained via social media (within the norms of data privacy), protocols to guide further retrieval, analysis and integration of such data with other standard safety data (obtained from standard PV sources) along with effective use of social media for risk management and communication.

Companies rely on multiple AE reporting channels such as email correspondences, company websites and physician hotline resources. There are now multiple sites and applications to capture patient and consumer AE reports on computers and smartphones. Companies are now actively engaged to identify and understand the value drivers for adopting a comprehensive PV social media strategy, which encompasses proactively creating social media platforms to solicit/capture AE data, rather than monitoring and reporting what comes in passively on existing company sites, and further examine the successes and challenges of the different types of social media platforms being used. Social media data offers some advantages over traditional AE reporting data or data mined from health and reimbursement records. Social reports are rapid, closer to real-time data (occurring in close proximity to the event) and potentially richer sources than reports filtered through HCPs. Social media is a promising source for new safety data and potential emergent safety signals. Yet, it is important to keep in mind that this data is essentially unstructured and obtained via uncontrolled and ungoverned processes in a non-regulated environment and is neither driven by data quality standards nor by specific business area orientation. At the same time, it is vital to carefully verify safety data obtained via social media for confirmation of the “identifiability” of both reporter and patient, address related data privacy issues and verify accuracy of reported safety data in lieu of potential bias introduced by the “reporter population”.

Pharmacovigilance Challenges and Solutions with Digital Media

Social media monitoring has become a standard practice in PV. Overcoming various social media hurdles for validation and consolidation of incoming data poses a great challenge, requiring the concerted efforts of PV teams. At the same time, careful evaluation and assessment of the use of social media as a PV tool needs to be constantly revisited; both in terms of meaningfulness and impact on outcomes. Understanding regulatory guidelines, current state and future considerations for use of social media in PV, possible areas of influence and expected challenges are critical, along with potential solutions and next steps. To learn more about future impact and potential areas to leverage social media in PV read this whitepaper.

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Comment mesurer le retour sur investissement des médias sociaux ? #esante #hcsmeufr


Infographie : comment les entreprises mesurent-elles l'apport d'une présence sur les médias sociaux à leur activité ?
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Social media project results in 13% more breast screenings  #hcsmeufr #esante #digitalhealth


An NHS project using social media to improve health by boosting digital inclusion has led to a 13 per cent increase in first time attendances for breast screenings in Stoke-on-Trent over four years. 

The local initiative saw information about screening posted on Facebook community groups, which empowered and enabled women to make appointments by reducing their anxiety around breast examinations. It also allowed them to communicate quickly and easily with health practitioners to ask questions about the screening process.

This project is part of NHS Digital’s Widening Digital Participation Programme, which is commissioned by NHS England and aims to make digital health services and information accessible to everyone – particularly the most excluded people in society.

Twenty digital inclusion pathfinders are being run across the country in partnership with the charity Good Things Foundation to test new ways to help people access digital tools to improve their health.

Nationally, attendances for breast screening are in decline and most recent figures, from 2016-17, show the proportion of eligible women taking up breast screenings in England fell to its lowest rate in 10 years.

In the last financial year, 7,938 women in Stoke-on-Trent either didn’t attend their breast screening appointment or opted out of going – meaning around 65 cases of potential breast cancer were not detected.

Through this project, the North Midlands Breast Screening Service promoted their Facebook page on local community groups which their target group – women aged over 50 – regularly visited.

The screening team posted information such as patients explaining about how the process of breast screenings work and how it has affected them, and videos showing the rooms where it takes place. Posts were designed to encourage women to share them and so spread the message about the benefits and importance of breast screenings.

The service’s Facebook page also answered questions in the group and by direct messaging, enabling women to book appointments more easily.

Data on attendances for first time appointments at the North Midlands Breast Screening Service shows they increased by an average of 12.9 per cent between three-year screening cycles from 2014 to 2018.


Gina Newman, Health Improvement Practitioner at the North Midlands Breast Screening Service, said:

“This is a fantastic idea and the community aspect of the group is so powerful that we now have 1,138 followers.

“We have seen an increase in the number of ladies who have booked and attended their appointments, who might not have done otherwise. It’s great to see the members supporting one another through their own journeys and sharing the page further with their family and friends.”

Pete Nuckley, Service Delivery Manager at Good Things Foundation, said: “It’s been fantastic to see the increase in attendance rates across the Stoke pathfinder area.

“It shows that being able to receive quality information about breast screenings and ask questions makes the whole process more human – and that’s key to engaging patients in their own healthcare.”

Juliet Bauer, Chief Digital Officer at NHS England, said: “The Stoke project is an example of how digital channels can be used to communicate with patients, providing local advice and answer key concerns.

“This work is part of the NHS’s wider commitment to digitally transform the way we work with all of our patients, improving the information we provide and empowering the public to take charge of their own health and care.”

A Facebook spokesperson said: “Our mission is to give people the power to build community and we are thrilled that Stoke-on-Trent Clinical Commissioning Group has been able to use Facebook to drive awareness of such a vitally important issue.”

Case study

Pam Lowe was prompted to go for breast screening thanks to the Facebook project.

“I’d had a call for my regular screening and fully intended to go,” said the 58-year-old.

“In the end, for one reason or another I missed the date.”

Then Pam saw a post in a Facebook group about the village where she lives promoting a visit by the mobile breast screening unit.

“I contacted them via Facebook Messenger and Gina Newman replied and told me it had moved on from my area, but she could sort me out with an appointment at the hospital instead. That was how I started the process and I made sure to see it through.”

She underwent the screening, which came back clear, and she has since encouraged her friends to use the service.

“I spend quite a lot of time on my iPad and on Facebook, which made it so convenient for me.

“Because of my positive experience, I share the page on Facebook and friends of mine have shared it too.

“It’s just a brilliant way to do it. I’ve told colleagues and friends alike to just go for it.”

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One doctor’s social media mission to discuss vaccination with parents  #esante #hcsmeufr #digitalhealth


As Romania fights a measles epidemic, Dr Mihai Craiu is using Facebook to turn the tide. His work has earned him a huge following – and 1st place in the 2018 Vaccines Today Communication Challenge’

In January 2017, Dr Mihai Craiu, a paediatrician in Bucharest, received some basic training in social media. It gave him the skills and confidence to do something he felt was sorely needed: join the online vaccine conversation to help parents understand the need for immunisation.

Romania has recorded thousands of measles cases this year and many blame the spread of misinformation online for declining vaccine uptake. 

‘Parents are using virtual media a lot – current data reveal that 74% of Romanians with a smartphone or desktop computer are going online first if they experience a health issue,’ Dr Craiu said.

‘I was concerned by the extremely low number of pro-immunization voices online. If anybody was searching online for information [in Romania] about a vaccine-related topic in 2016 or 2017 the first page they would find was full of anti-vaccination opinion. I realised that a Facebook page can reach more people than I could see in our clinic.’

That was the inspiration for his Facebook page (Spitalul Virtual de Copii) – a hub of information and a forum for conversations about vaccines and other child health topics. More than 100,000 people now follow the page and some of Dr Craiu’s videos have been viewed half a million times.

‘I spent at least three to four hours per day, but it has been a huge real-life experience,’ he said. The main challenge is responding to questions from parents – many of whom Dr Craiu believes decide to vaccinate their children after having their concerns addressed.

He said he has learned a great deal through using social media and has been sharing his experience with paediatricians, GPs and other health professionals – most recently at the 3rd Balkan Paediatric Meeting. 

Dr Craiu won first prize in this year’s Vaccines Today Communication Challenge. The contest set out to find Europe’s vaccine champions – those who actively advocate vaccination. He will present his work at the Excellent in Paediatrics conference in Prague at a roundtable event hosted by the Coalition for Life-Course Immunisation.


Read a full transcript of the interview below

What is the situation today in Romania regarding vaccine uptake? 

Unfortunately, it is slowly but constantly decreasing since 2010. According to the National Institute for Public Health (CNSCBT) we are now below the herd-immunity cut-off. The latest annual report shows a constant downward trend for measles-mumps-rubella vaccine uptake. Only 74.5% of children have had two doses of vaccine. So, the current epidemic could have been prevented because there have been serious warnings since May 2016.
Using three doses of DTP as a surrogate-marker for immunization, we also see a decrease, according to UNICEF data which puts the current level at 84% nationally. However, in some counties in Romania, it is as low as 50%. 

Is there widespread public concern about measles cases?

Yes, there has been constant coverage by media and official weekly reports from the CNSCBT on total number of confirmed cases and number of deaths. But the loudest voices are those of the anti-vaccine movement claiming that these numbers are incorrect and over-report measles cases and deaths.

Are you concerned by the level of anti-vaccine commentary in the media and online?

Yes, I am concerned because these rumours have grown into a structured movement with political implications. Clergy members, religious groups, artists and lawyers are joining forces.

There is a broad group of parliament members (more than 80 people) that have been able to block the Immunization Law. The Health Ministry appointed a group of experts two years ago when the first cases of measles were confirmed. I was appointed as a paediatrician, but there have been GPs, microbiologists, infectious diseases experts, epidemiologists, lawyers, and specialist representing the child-protection authorities among others.

The Immunization Law was evaluated by Health Ministry experts and then presented for a public debate. I was terrified by the verbal violence of opponents. Finally, after six hours of parallel dialogues, no basic consensus could be reached. The Senate had a relative short debate on this project and generated a positive vote. But the lower chamber of Parliament has the deciding vote. For more than a year there has been no progress.

Where does that leave the public debate?

Today there are no consequences for providing any fake-news regarding immunisation in Romania. The anti-vaccine people went so far as to distribute flyers by mail with UNICEF,WHO and Health Ministry logos stating that vaccines are harming children and are producing the measles epidemic. Dr Pintea, our Health Minister, has said that legal prosecution will follow. 

Do you also hear these concerns from parents in your clinic? How do you respond?

Parents are extremely vocal in social media, both pro and against vaccination. In the clinic most of the people that approach physicians are hesitant people. Some of them are not opponents of all vaccines. MMR uptake is still affected by the bad Wakefield story and we are still debating with many parents on autism causality issues. There are also a large group of parents who are hesitant because their GP is hesitant.

With my colleagues from the National GP Society we produced short online cases or scenarios related to vaccine-preventable diseases. We also posted, on the Society portal, a structured catch-up schedule for those children whose parents can be convinced. This portal is open also for lay people.

When did you begin using Facebook to communicate about paediatrics and vaccination?

More than four years ago we started to provide online education for parents of children with asthma through our Institute’s online portal. The Virtual Asthma Hospital has proven that people are reading these posts. And children that were instructed to use this portal were less likely to have unscheduled medical visits to the Emergency Department. We were able to present a paper at an international conference on the Virtual Asthma Hospital impact on quality of life.

Parents are using virtual media a lot. Current data reveal that 74% of Romanians with a smartphone or PC are going online first if they experience a health issue. Only 26% are asking their GP. So, I realised that a Facebook page can reach more people than I could see in our clinic.

I attended a training session in Bruxelles in January 2017. I was concerned by the extremely low number of pro-immunization voices online. If anybody was searching online for information about a vaccine-related topic in 2016 or 2017 the first page they would find was full of anti-vaccination opinion.  

There are some isolated voices of physicians like Irina Costache, mother of two and paediatrician. Her blog, Mamica Pediatru, is a nice and positive voice. Prof Maria Livia Ognean, neonatologist and one of the most active physicians on-line, has a page called Baby Care Sibiu. And Dr Otilia Tiganas, a GP in a small rural area of western part of Romania writes a blog with a simple and sometimes humorous approach to medial issues – Blogul Otiliei.

Has your social media work been a success? 

I think so – last year at the COPAC Gala my Facebook page (Spitalul Virtual de Copii) was awarded a special prize in a communication contest. It was the first time that a paediatric pro-immunization page was nominated for such a competition in Romania.

More than 97,000 people are reading this page and a lot of children have been immunized after their parents had an online pro-con debate on this page. Positive open dialogues on vaccine related-issues are common on my page. It is not entirely dedicated to vaccines but covers a rather large area of childhood diseases or health-related issues like growth and development, emergencies, diet etc.

Have you had any negative experiences?

Yes, several. But during my 20 months experience I found the right approach – I hope! Some unexpected negative experiences were related to other physicians that were not very happy – unfortunately we have some doctors in Romania that are organizing, along with religious groups or notorious anti-vaccine champions, public events where fake science is promoted.

How do you respond to anti-vaccine comments on Facebook?

If they are aggressive or deliberating misleading I warn them in a polite manner. Some fake-news are useful because I can answer in a scientific way and I am able to provide data and documentation sources for hesitant parents. A lot of hesitant people sent me private messages seeking guidance or even asking me to immunize their child.

Some vulgar or aberrant posts are deleted. But more than 90% of my Facebook followers are rather polite.

Would you encourage other health professionals to use social media in this way? 

Yes, I have presented my work at several local or regional meetings. This month I was an invited speaker at the 3rd Balkan Paediatric Meeting where I presented my online activities. Next month I will attend a national joint meeting of paediatricians, GPs and media people and I will present also a SWOT analysis of my Facebook page.

What skills or training do you need, if any?

I need better skills for video editing – short videos are the most commented posts on my Facebook page. One of them had more than 500,000 views. 

A lot of trouble-shooting issues are also needed – how to respond to a special type of approach? Tailored "treatment" in a rising rather aggressive Romanian Social Media environment is needed.

Does it take a lot of your time? 

Yes. At least 3-4 hours a day. But it has been a huge real-life experience. During a one-to-one dialogue in hospital I am rather protected. I am in a comfortable position of being a senior physician and patients are rather compliant. But online I have met the real patients. There are no limited on sincere and uncensored dialogue.

One parent has said: "If I am not in the GP’s office I can ask about my fears or dilemmas. You are listening. Or at least you cannot interrupt my questions…".

Do you believe your social media work is having an impact on public attitudes? 

Yes. Or I hope so! Many of my residents and students in medical school have changed. And our hospital is now the leading paediatric hospital in parental perspective. Because dialogue style changed. 

The future is now. Social media tools will impact more and more medical issues – not only vaccination. 

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Social Media’s Eroding Trust Hits Healthcare Companies - #esante #hcsmeufr #socmed #digitalhealth 


It’s not exactly a well-kept secret that the pharmaceutical and biotech industry isn’t among the world’s most trusted. This runs in stark contrast to their seemingly noble intentions: to bring new therapies to market that improve people’s health.

With such an important mission, why do public trust issues seem to persist for healthcare companies? There are a lot of contributing factors that likely play a role, including perceptions regarding price hikes to access to medicines, but there’s no questioning that the pharmaceutical and biotech industry has a reputation issue on its hands.

O'Dwyer's Oct. '18 Healthcare & Medical PR Magazine

This is a real business problem. You won’t find “reputation” on any balance sheet but it’s most certainly something that impacts overall business performance. Look no further than the string of reputation harm that faced United Airlines in 2017. In two separate incidents, one where three passengers were denied boarding due to their attire, and one where a passenger was dragged off the plane after refusing to exit voluntarily, United failed to apologize or even respond in a timely manner. During this period of silence, United’s market valuation dropped to the tune of $1.8 billion. In a matter of days, United had done serious harm to its reputation, its relationship with customers and ultimately, its business.

Pharmaceutical and biotech companies are taking notice and evaluating how to change the discourse and engender trust with their stakeholders. One area where there’s opportunity to develop a different type of relationship is through digital and social media. It offers a more direct line to external stakeholders, an ability to demonstrate empathy and put forward a more human voice for a company. These benefits are well understood but adoption of digital and social media as more than a push marketing channel and a customer service vehicle in pharma remains low.

There are the usual hurdles that slow adoption in this industry. Regulatory and medical guidelines place significant restrictions on what can and cannot be communicated. A risk-averse culture often prevents pushing the envelope to embrace a customer-service mindset on social media. But those hurdles are nothing new. For years, we’ve dealt with the same restrictions and found ways to effectively communicate through digital and social channels. So, what’s changed? Trust. Trust in the companies and trust in the channels themselves.

Over the past 18 months, we’ve seen the trust in information communicated on social media called into question. What was once seen as a possible ready-made solution to form a more direct relationship with the customer is now facing its own scrutiny and all information is being placed under an intense microscope.

This was driven by a series of high-profile issues that garnered national attention. The first was the widely-held belief that foreign entities used social media to disseminate misinformation during the 2016 Presidential election. This was the first time that the use of social media for nefarious intentions rose to the level of being squarely placed in the national discourse. It caused people to question the legitimacy of content on social media channels and specific scrutiny was placed on content produced by companies as opposed to individuals. Just as this conversation was beginning to shift to the back burner, the Cambridge Analytica scandal broke. This caused more angst amongst pharmaceutical and biotech companies because it involved sensitive data, which in the world of healthcare, is always a hot topic. Put these two issues together, and the very thing pharma hoped would be a tool in repairing its trust issues ended up becoming a trust issue of its own.

This leaves pharmaceutical marketers in a predicament. Do they abandon the use of social media channels as a customer service mechanism that can help to build and repair public trust? Are the channels themselves a strong headwind against that effort?

Like most things, the answer is murky. What is clear is that social and digital channels can be used to unlock a more direct connection with the audience. A well-thought-out response plan and an escalation procedure that pinpoints who can make decisions quickly allows pharmaceutical and biotech companies to respond on social media in near real-time. This is a far cry from the seemingly impassable chasm that previously existed between healthcare companies and their stakeholders. With the advent of enterprise-ready chat bots and machine learning, we are also now able to take this response protocol beyond simply manual responses based on pre-approved response matrices. These tools allow us to apply the same business process but enable true real-time engagement.

As these tools reach maturity, in order to tap into their true potential, we need to address the thorny question of what does the audience really trust on these channels. There are so many factors that go into trust that it is important to uncover what and why a piece of content is more trusted versus another. It could be the channel itself that is more trustworthy; perhaps users prefer one channel over another as a source of information. It could be that the copy has the greatest impact on effectiveness or the creative that accompanies the content. It could also be the publisher itself and not the channel or content that has the greatest impact on trust. All of these are important variables to understand how to serve content across social media and how public trust plays a role in the efficacy of that content.

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Using Social Media to Meet Healthcare Business Objectives #esante #hcsmeufr #socmed #digitalhealth


Slides for my October 17, 2018 webinar for the Indiana Society of Physician Recruiters
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#VerifyHealthcare Adds Integrity to Medical Social Media Posts #esante #hcsmeufr #socmed #digitalhealth


Just like fake news, untrustworthy health information problematically circulates across social media platforms, often posted by people who lie about their medical credentials online. One social-media-savvy doctor noticed this dangerous issue and decided to do something about it. Austin Chiang, MD, MPH, Director of the Endoscopic Bariatric Program at Thomas Jefferson University Hospital in Pennsylvania, launched the #VerifyHealthcare social media campaign to encourage the integrity of medical information online.

Dr. Chiang’s involvement and research on using social media for gastrointestinal health education and outreach led to his appointment as Chief Medical Social Media Officer of Jefferson Health/Thomas Jefferson University Hospitals. He spoke with CareDash about his #VerifyHealthcare mission.

You started #VerifyHealthcare, an Instagram and Twitter hashtag. Tell us what it is and what your inspiration/motivation was.

My idea behind the #VerifyHealthcare movement was to encourage anyone online who regularly disseminates health information or knowledge to disclose their qualifications and to encourage followers to research who they trust for this kind of information online. There is no clear entity regulating the integrity of health information on social media, and in this day and age when social media is so pervasive, this could have serious public health consequences. Through my own experience witnessing a boom in health influencers especially on Instagram over the past year, I have noticed not only accounts that are openly distributing unsubstantiated health claims, but also professional misrepresentation.

What are common types of misinformation you are seeing? Are there any especially egregious examples you’ve seen?

Aside from non-evidence based health claims of various fad diets and unproven treatments, I also noticed professionals such as pre-medical students and medical students posing as physicians and distributing health tips or promoting certain supplements or products that claimed health benefit. Furthermore, some allied professionals such as chiropractors and naturopathic medicine professionals were claiming to be physicians who had gone to "medical school." While the purpose of this campaign is not to serve as the "social media police," I sought to highlight the strengths of health professionals who were qualified to speak on various topics.

Tell us about your practice and expertise.

I am a triple board certified hospital-based gastroenterologist focused on advanced endoscopic procedures and weight loss endoscopy. I serve as the Director of Endoscopic Bariatric Program at Jefferson Health in Philadelphia, PA.

I’ve never heard of a hospital with a Chief Medical Social Media Officer. What does that entail? Should we follow our hospitals and providers on social media?

This title reflects Jefferson's dedication to innovation, a spirit spearheaded by our CEO, Dr. Stephen Klasko. The role includes encouraging health professionals to be active on social media, to revise our social media policies, and to assist in online campaigns.

What do doctors do if they see another physician who may be spreading incorrect or unsafe information on social media?

Often, there is not much we can do to control what others are posting. We do, however, have control over what we post. Therefore, we can contribute our own post promoting accurate health information that cites results from peer-reviewed publications. Individuals are entitled to express their personal beliefs, and everyone has a different way of approaching such a situation. Part of the beauty of social media is that it is meant to be "social." Therefore, an open discussion may allow the posting physician to clarify miscommunications and encourage others to weigh in. Similarly, an offline discussion is also one way of communicating with the physician to better understand their rationale. Of course, these exchanges must remain professional and respectful.

If you had one piece of advice for CareDash readers regarding health information on social media, what would it be?

Social media is only one source of information, and it is best to double and triple check both the presented knowledge itself and the professionals who are posting through other sources (including official avenues like board certification and licensure websites) before trusting medical information.

Social media is here to stay, and given how pervasive it is and how widely it is already being used as a marketing and advertising tool in other industries, I expect its impact on public health to only become more substantial as time goes on.

About the Expert: 

Dr. Austin Chiang, MD, MPH, is one of the few bariatric endoscopy and advanced endoscopy dual-trained gastroenterologists in the world. Dr. Chiang is the Director of the Endoscopic Bariatric Program at Thomas Jefferson University Hospital, where he offers unique endoscopic weight loss solutions for those seeking a less invasive method of losing weight and improving metabolic conditions such as high blood pressure and diabetes. Customized treatments to enhance weight loss in those who previously underwent bariatric surgery are also available and effective.  

You can also tweet us questions and comments @caredash.

About the Author

Ted Chan

Ted is the Founder, CEO, and Senior Editor of CareDash.

Ted created CareDash after noticing two troubling trends on healthcare review sites: healthcare providers serving certain segments of the U.S. population were underrepresented and many existing sites accepted financial compensation in exchange for removal of negative provider feedback. transparency and improve the quality of healthcare information available for all Americans.

In addition to his career as a technology executive, Ted is an accomplished writer and editor, with writing credits that include the Boston Globe, ESPN, and the Middlesex News.  A sought after healthcare industry expert, Ted has been quoted in publications such as MedCity News, Becker’s Hospital Review, and VentureBeat.

Ted received his Bachelor of Arts in History and Psychology with High Honors from Swarthmore College, and MBA from MIT Sloan School of Management.  Ted also studied Value-Based Healthcare at Harvard Business School.

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Observations from Social Media Regarding the Symptomatology of Adult Hydrocephalus Patients #Esante #hcsmeufr



Hydrocephalus patients experience symptoms related to hydrocephalus in an age-dependent manner. However, prevalence estimates of hydrocephalus symptoms in young and middle-aged (YMA) adult patients are rare and variable. Highlighting the importance of hydrocephalus symptom management, the persistence and intensity of headache or gait disturbance have been associated with signs of brain white matter integrity loss, including in treated YMA adult patients. Thus, it is important to ascertain which symptoms adult hydrocephalus patients report most to confirm their relative importance.


Observations of symptom complaints were made from publicly viewable online responses to an inquiry posted by the Hydrocephalus Association to two Facebook webpages.


Within seven days of inquiry posting, 381 complaints of signs and symptoms were identified in 82 online responses. Headache, cognitive deficits (cognition and memory), and mobility issues (dizziness, balance, or gait problems) were most commonly reported by 63%, 45%, and 40% of respondents, respectively. Results were highly similar for the subgroup of 53 patients reported as treated. For self-identified YMA patients (< 60 years old), results were similar, but with fewer mobility complaints. Not previously reported, hypersensitivity to external stimuli was reported by half of the patients that reported headache.


The current results provide further quantitative support for the prioritization of study of headache, cognitive deficits, and mobility issues in YMA adult hydrocephalus patients. Warranting further study, cranial hypersensitivity to external stimuli may represent a novel outcome measure, and treated YMA adult hydrocephalus patients continue to report symptoms associated with signs of brain damage.

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The Med in Social Media: The Role Twitter Can Play in the Medical Student Toolkit #esante #hcsmeufr #digitalhealth


Medical school is a melting pot of passions and intellect. Therefore, I was surprised when it was here that I felt, for the first time, alone in my interests. I had fallen in love with the idea of using social media as a health care tool for both patients and providers. However, this concept is still in its infancy. With colleagues dedicated to so many different projects, it was difficult to convince them to join a movement that is still finding its place in medicine. Additionally, many of us are wary of putting our professional reputations at risk before they even have a chance to form. Statements made on social media in the heat of the moment can come back years later in haunting ways. A poorly thought out or timed tweet can become viral in minutes.

While I found this discouraging, the very platform I was trying to promote provided me with relief. On Twitter, I could find the conversations I craved with a simple #hashtag filter. Even when I didn’t know what I was looking for, I asked questions, and a simple like reminded me that I was not alone in my questioning. I followed mentors I admired, shaping my newsfeed into a flow of articles I cared about. Through them I learned of other hashtags and “mentors” I could follow. The quotations only indicate that most of these mentors probably are unaware of how they are influencing my personal career decisions and growth.

I happily grew into my lurker position and reached out of it occasionally. I learned about conference hashtags and was instantaneously given highlights from sessions occurring across the nation. It was easy asking clarification questions on Twitter knowing that people could respond in their own time. I enjoyed the false sense of security an online platform gives sometimes shy people like me. A few months ago, I participated in a tweetchat: #hcsm (healthcare social media). The interactions inspired me to break out of my comfort zone and directly message social media guru @DanamLewis, who founded the open source artificial pancreas system movement #OpenAPS. She agreed to speak for our Healthcare Innovations and Technology Student Interest Group, which is devoted to sharing news about improved patient care through the use of technology. It was the most attended event all year.

I currently hover in my personal bubble as a medical student on Twitter. I turn to it for information from trusted sources and am often pleasantly surprised by the interactions I have. While I tend to overthink social interactions with those above me on the medical hierarchy, the constant flow of tweets coming in from around the world allows me to let go of the expectations that I should get a response. Additionally, there is no obligation to post. I can use Twitter for as much or as little as I want, and it has been this versatility in usage that has convinced me of its invaluableness as a tool for the modern medical student.

I wrote this post with the guidance of both mentors and “mentors.” I look forward to the day when all medical students feel comfortable enough to add Twitter to their medical school toolkit. For all those who agree or disagree, I am putting out a call to action. A few peers and I who turn to social media for different reasons are coming together to formulate Twitter Guidelines, written by and for medical students. Guidelines for using Twitter as a medical educator, for example, already exist. If you have any experiences that would help us in our efforts, we would love to hear from you. You can email us at or find me on Twitter @lamvivianw!

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Surveiller l’#épidémie de #grippe grâce à #Twitter, c’est efficace #socialmedia #Sociallistening #hcsmeufr #Esante #Patient 


Surveiller l’épidémie de grippe grâce à Twitter, c’est efficace
Le nombre de tweets relatifs à la grippe publiés sur le réseau social suit la même courbe que les consultations médicales. Selon Santé publique France, Twitter pourrait aider à surveiller les épidémies.
GIE_GERS's curator insight, October 31, 6:14 AM
Surveiller l’épidémie de grippe grâce à Twitter, c’est efficace

Le nombre de tweets relatifs à la grippe publiés sur le réseau social suit la même courbe que les consultations médicales. Selon Santé publique France, Twitter pourrait aider à surveiller les épidémies.

Synthesio Acquired By Ipsos, Reinforcing Social Media Intelligence Capabilities  #esante #hcsmeufr


Enhancing customers’ understanding of online conversations and enabling the transformation of social data into strategic business insights NEW YORK, Oct. 30, 2018 (GLOBE NEWSWIRE) -- Synthesio, the company behind the leading global Social Media Intelligence Suite, is pleased to announce that it has been acquired by Ipsos. Founded in 1975, Ipsos is the market research and opinion leader, headquartered in Paris, with over 16,000 employees and a presence in 89 countries.
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Machine learning to support social media empowered patients in cancer care and cancer treatment decisions  #esante #hcsmeufr



A primary variant of social media, online support groups (OSG) extend beyond the standard definition to incorporate a dimension of advice, support and guidance for patients. OSG are complementary, yet significant adjunct to patient journeys. Machine learning and natural language processing techniques can be applied to these large volumes of unstructured text discussions accumulated in OSG for intelligent extraction of patient-reported demographics, behaviours, decisions, treatment, side effects and expressions of emotions. New insights from the fusion and synthesis of such diverse patient-reported information, as expressed throughout the patient journey from diagnosis to treatment and recovery, can contribute towards informed decision-making on personalized healthcare delivery and the development of healthcare policy guidelines.

Methods and findings

We have designed and developed an artificial intelligence based analytics framework using machine learning and natural language processing techniques for intelligent analysis and automated aggregation of patient information and interaction trajectories in online support groups. Alongside the social interactions aspect, patient behaviours, decisions, demographics, clinical factors, emotions, as subsequently expressed over time, are extracted and analysed. More specifically, we utilised this platform to investigate the impact of online social influences on the intimate decision scenario of selecting a treatment type, recovery after treatment, side effects and emotions expressed over time, using prostate cancer as a model. Results manifest the three major decision-making behaviours among patients, Paternalistic group, Autonomous group and Shared group. Furthermore, each group demonstrated diverse behaviours in post-decision discussions on clinical outcomes, advice and expressions of emotion during the twelve months following treatment. Over time, the transition of patients from information and emotional support seeking behaviours to providers of information and emotional support to other patients was also observed.


Findings from this study are a rigorous indication of the expectations of social media empowered patients, their potential for individualised decision-making, clinical and emotional needs. The increasing popularity of OSG further confirms that it is timely for clinicians to consider patient voices as expressed in OSG. We have successfully demonstrated that the proposed platform can be utilised to investigate, analyse and derive actionable insights from patient-reported information on prostate cancer, in support of patient focused healthcare delivery. The platform can be extended and applied just as effectively to any other medical condition.

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How social networks improve the world of medicine for cancer patients  #esante #hcsmeufr


A cancer patient’s journey is complex, intricate and sometimes confusing. This is especially true as cancer is considered to be a life-altering condition that impacts the physical, emotional, social and economic aspects of patients and their families.

When it comes to diagnosis and treatment, Electronic Health Records (EHRs) serve an important purpose – providing up-to-date information about patients and streamlining coordination between different hospitals and clinic departments, with the goal of improving diagnosis and care. However, while EHRs are a crucial step toward value-based healthcare, they are intrinsically limited, because they only capture half of the patient’s picture: the physician’s perspect,


Cancer patients – from early diagnosis through treatment and beyond – often have many medical experiences that don’t find their way into the EHR. 

Why are many patients not forthcoming when discussing complex and personal topics with their doctors? The reasons for withholding information varies from person to person, but it is not uncommon to hold back due to discomfort and embarrassment. 
Controversial or highly personal topics can be particularly difficult to discuss openly. In fact, many patients feel much more comfortable sharing and discussing this information anonymously with other patients who are in the same situation, rather than with their own doctors. That being said, the question that arises is, how can healthcare systems gain better insight into how cancer patients navigate the complex facets of their diagnosis and treatments to enable physicians to help them further? 

The answer lies in the powerful combination of EHRs with the patient’s own recorded experiences. It is obvious that social media plays a major role in today’s society and there are many social platforms that have changed the way that we form communities. What makes social networking so special is the ability to communicate with people who share similar journeys. This creates a larger worldwide community that can help them to find others to talk to and lean on in a time of need. 

For cancer patients, this aspect of community interaction is essentially crucial.

With the Belong app, access to a cancer-focused social network provides a full range of personal experiences, leveraging data and insights provided by more than 130,000 global cancer patients. Because social media offers patients the ability to speak freely and anonymously, nothing is off-limits – creating a truly open and honest dialogue.  


Being able to ask questions, voice concerns and speak without fear of judgment is liberating for the patient, and has the added benefit of providing treating doctors with a better understanding of what cancer patients are thinking and doing in the real world 

Access to this information can also help health providers and payers identify patterns for correct drug usage, schedules and related side effects. Equipped with this added insight, physicians become more knowledgeable when advising patients, which eventually leads to better treatments and outcomes.

Social applications hold the key to significant, previously unreported patient data. As more physicians and providers tap into large cancer-specific social communities, this added value positively impacts the entire cancer treatment process. 

We can use social app tools to educate patients and their caregivers about what steps to be taking, including diverse treatment protocols and possible side effects and outcomes. At the same time, we can increase their adherence by keeping them informed with regular reminders, reports, measurements and surveys.

Together, the combination of EHRs and social insights will provide an invaluable tool for patients, physicians and the whole health system through the cancer patient’s entire journey.

The writer, the medical director of Belong.Life, is a renowned oncologist with 40 years of experience. He previously served as executive board member of the International Committee of the American Society of Clinical Oncology and was the founder and medical oncology director of the Sandton Oncology Centre in Johannesburg, South Africa.


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