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JMIR-Using Social Media to Target Cancer Prevention in Young Adults: 


Cancer is a leading cause of death in the United States and a major growing public health burden. Primary prevention is an important strategy of focus as the burgeoning scientific research supports the notion that a large portion of cancer is preventable [1,2]. Although the etiology of cancer is multifactorial and complex and differs across specific types of cancer, it has been well established that approximately 50% to 60% of all cancers can be reduced with behavior change such as vaccination, physical activity, weight control and maintenance, reducing alcohol consumption, and smoking cessation [3,4]. Given this context, it is critical for public health efforts to prioritize the fostering of positive health behaviors to reduce the future burden of cancer.

Many of these health behaviors are considered modifiable risk factors, and to an extent, may be more susceptible to change and influence during critical age periods over one’s life course. Cancer prevention efforts have traditionally focused on older adults aged 40 years and over, who tend to be eligible for most cancer screenings and have more health awareness as they naturally experience more health issues with aging. However, much less attention has been paid to cancer prevention strategies targeted to younger age demographics, such as those aged 18-29 years, and, in particular, to strategies tailored through the use of new media. It is imperative to target young adults to promote cancer prevention behaviors before cancer develops. This younger age group is a critical developmental period that can set the stage for forming mindsets and worldviews that will ultimately shape future health habits and lifestyles [5,6]. Although cancer does not commonly occur in this age group, it is important to focus on prevention earlier in life, as cancer exposures are generally thought to occur earlier in life and contribute to cancers that are more commonly diagnosed among those 40 years and older (eg, lung, breast, colorectal, and prostate). Cancer prevention behaviors include these upstream behaviors, which can be modified earlier in life and directly relevant to young adults, as well as the more proximal action of completing recommended cancer screening, which is generally not relevant to young adults for the most common cancers (breast, prostate, and colorectal cancers).

The generation of young adults born from 1995 onwards are considered digital natives and defined as people “born or brought up during the age of digital technology and therefore familiar with computers and the internet from an early age” [7]. Young adults aged 18-29 years are the most frequent users of social media; in 2016, 86% of them used at least one social media site [8] and 92% engaged with 2 or more devices simultaneously including mobile phones, tablets, PC, and TV [9]. Social media must be considered as a public health strategy in young adults, simply because it is embedded in their everyday lives. To effectively reach them, health communication must occur where they are, engaging in online platforms, and must also be tailored using effective cancer prevention messaging uniquely suited for particular online platforms. For example, Twitter messages are limited to 280 characters and cancer prevention messaging to younger populations must take into design the linguistic and cultural factors in how to effectively communicate and engage young adults through Twitter.

In this viewpoint paper, we focus on social media and past use in primary cancer prevention in the general population and discuss how these studies can be applied to young adults to reduce the burden of cancer in the next generation of older adults. We reflect on the current state of the field and offer discussion on how previous research has implications for considering measurement and theoretical issues in future directions of research. Specifically, we provide an example of theoretical considerations from our current work (Lyson et al. Social media as a tool to promote health awareness: results from an online cervical cancer prevention study. Under review, submitted April 2018), describe various types of studies using social media for health communication with young adult digital natives with supporting examples, highlight methodological considerations in conducting studies in this field, and propose to integrate the life course perspective of cancer prevention with new forms of media, both of which overlap in the focus on young adults and lifestyle behavior change to present a unique opportunity for researchers to test effective cancer prevention strategies using social media.


Theoretical Considerations

Theoretical considerations are an important component in conducting rigorous research in social media and health. Specifically, behavior change interventions are most effectively guided and tested by conceptual frameworks appropriate for the target audience. As an example, in our past and current work, Bandura’s social cognitive theory, an interpersonal-level health behavior theory [10], has been the most relevant theory to apply to research questions focused on social media influences on health behaviors. This theory encompasses social influences on health in a wide variety of settings and can naturally be extended to the social media environment. Social cognitive theory is used to explain how people learn behaviors by observing others and through vicarious reinforcement. It emphasizes reciprocal causation of behaviors between the self and society, in which personal factors in the form of cognitive, affective, and biological events, behavioral patterns, and environmental events all operate as interacting determinants that influence each other bidirectionally, that is, “reciprocal determinism” (Figure 1). As part of the environment, Web-based social media frames and reinforces social norms; social media sites have their own “rules” for reinforcement of messages and content in terms of likes, shares, and comments that are much more explicit than in everyday life.

When applied to social media communication, social cognitive theory suggests that new ideas, values, behavior patterns, and social practices are rapidly diffused worldwide through observational learning, in part through social networks. The concept of reciprocal determinism is critical to behavior change via Web-based social networks. Not only do individuals learn facts and information from social media but they are also actively shaping the social media sites to be broader networks for social change or political movements through their participation. This reciprocity sets the stage for peer-to-peer influence, as in studies in which groups interact via Web-based social media to address health issues. Furthermore, social media enriches the availability of public health data in the environment; in Bandura’s model, social media provides a “socially mediated pathway” to disseminate communication by linking people to social networks and community settings that provide natural incentives and continued personalized guidance for desired change. The social media activities of public health organizations, such as vaccination campaigns from the Centers for Disease Control (CDC) delivered via Twitter, allow for dissemination and reinforcement of health behaviors. The concept of “observational learning,” that individuals learn from watching others perform a given behavior, informs how behavior can spread via Web-based social media.

Figure 1. Reciprocal determinism in Bandura’s social cognitive theory for behavior change. View this figure


Current Research in Social Media and Health

Public health research using social media takes place on a spectrum ranging from using social media as a real-time data source to engaging target populations online to influence health behaviors. Automated analysis of passively collected social media data can be used for disease or behavioral surveillance, including for early identification of disease outbreaks [11]. Public health organizations also deliver health information and health promotion messages using social media. In fact, the CDC has a social media toolkit intended to facilitate public health communication efforts via social media by partners and stakeholders [12]. This approach is unidirectional; experts deliver content to lay participants. The assumption in this approach is that populations at risk are willing and able to engage with health-related content and subsequently modify behavior. More recently, public health researchers have used social media to deliver health interventions that harness the immediacy of Web-based communication as well as the influence of Web-based social networks [13]. In social media intervention research, researchers interact with participants online, and participants may interact with each other. To augment our viewpoint discussion, we highlight various study designs that have been employed using social media data sources, provide supporting examples from the literature, and discuss implications for future research in social media and health.

Observational Studies Using Social Media Data Sources

Because individuals, especially young adults, publicly share health information online, social media data can provide a robust data source for behaviors that are difficult to characterize and health data that are unavailable through traditional surveillance methods. This method of “mining” social media data for public health purposes is perhaps the most widely developed type of social media health research [14]. This type of observational research may be less prone to bias as people on social media typically do not act as though they are being observed for the purpose of research, in contrast to traditional research methods that explicitly recruit people to participate in research in academic settings and ask people to report on health-related behaviors. Myriad examples of this type of work exist across disparate public health domains including substance use [15], body weight-associated stigma [16], and infectious disease surveillance [11,17]. For example, Lyles et al performed this observational type of analysis for cervical cancer prevention discussions among young women on Twitter [18]. The analysis demonstrated that women do share publicly their experiences with cervical cancer screening, often with language encouraging peers to undergo screening as well. These user-generated health promotion messages are useful for characterizing public sentiment and informing public health messaging content. More recently, we analyzed Instagram data to characterize misuse of codeine on social media and found that codeine misuse was commonly represented with the ingestion of alcohol, cannabis, and/or benzodiazepines [19]. Our findings suggested that codeine misuse was represented as normalized behavior and found in mainstream commercialization of music and cartoons on social media. Because health behaviors are often difficult to capture in traditional observational research studies that rely on self-reported survey data, social media provides a unique lens through which stigmatized behaviors can be observed through a “fly on the wall” perspective.

This literature demonstrates that public health professionals can learn about community perceptions of cancer prevention-relevant behaviors by examining social media content. There is still much unrealized potential for connecting social media content and sentiment to real-world health behaviors. Thus far, one effective use of social media data has been in the area of “infoveillance” such as in influenza forecasting [20] and real-time outbreak identification [21]. Using geocode tags from social media data content could likewise be used to geographically pinpoint challenges and opportunities in cancer prevention behaviors; this methodology has been previously applied to infectious disease outbreak research. However, as a typical methodological concern for all self-reported data, the information on the user’s location is largely based on what is provided in their user profile, which may not be complete or accurate information. For Twitter data, it is estimated that about 1% to 2% of tweets are shown to be geotagged [22].

Observational studies using social media data have the advantage of accessing vast amounts of public data readily available in real time. This immediacy is a major advantage of using social media data to inform public health surveillance. However, methodological challenges remain in conducting rigorous and unbiased studies using social media data. Social media data are user-driven data and depend on the population who chooses to publicly share information. This is a self-selected group and may not represent the general population. Access to the internet and privacy concerns influence the likelihood of posting information online [23]. Internet access, particularly on mobile devices, is growing rapidly among young adults, and mobile internet is well suited to social media use. Privacy concerns are common, but younger adults compared with older adults are more likely to have shared personal information online [23], potentially enhancing generalizability in this age group. A second limitation of social media content as a public health data source is its unstructured nature, making comparisons across platforms or even individual messages challenging. Moreover, it is often impossible to verify the identity or other relevant details about individuals who post online. In general, social media posts often lack identification, demographic information, and other details. Social media data analysis must be interpreted in light of these inherent limitations.

Unidirectional Mass Communication Health Promotion via Web-Based Social Media

Governmental organizations such as the CDC and the National Cancer Institute have used social media marketing strategies to deliver a wide array of health promotion content through multiple dissemination channels and platforms, such as blogs, Twitter, and Facebook [24]. Researchers have also used an online marketing approach for cancer prevention. As an example, Cidre-Serrano et al used Google AdWords to display skin cancer prevention messages on individuals’ search results page when users searched for tanning beds [25]. These prevention advertisements were displayed over 200,000 times over 2 months with a click-through ratio of 1%, which is generally considered sufficient for commercial purposes. Google for NonProfits and other Web-based platforms provide a limited amount of free advertising for nonprofit organizations, making this a low-cost approach for qualifying organizations. In general, the unidirectional strategy of “pushing” content at individuals has the advantages of being low-cost with a significant reach, as well as the ability to target content to specific high-risk groups (eg, young women who use tanning beds). However, data are lacking about the effect of health promotion messages delivered online. An example of planned work to address this gap would be to learn whether a Facebook advertising-based intervention aimed at reducing indoor tanning would shift knowledge and attitudes about indoor tanning and reduce individual intent to use tanning beds to ultimately prevent melanoma in high-risk groups.

Web-based social media is a powerful advertising and marketing tool as 88% of businesses use social media [26]; however, commercial entities have been shown to use social media to promote unhealthy behaviors. For example, Ricklefs et al documented the indoor tanning industry’s use of social media as a strategy for maintaining relationships with customers and to offer pricing deals that promote high-frequency tanning [27]. Similarly, e-cigarette advertising is prevalent on Twitter, particularly in states that limit other forms of tobacco advertising [28].

Provision of public health information or promotion via social media is subject to many of the same limitations as mass-media public health campaigns [29]. Social media messages are well integrated into the lives of users and can be easily accessible when they need it the most. The potential for health campaigns to go “viral,” increasing the audience size and impact, is a theoretical advantage of social media campaigns compared with traditional approaches, but it cannot be predicted or planned. Insomuch as content is easily accessible, it is, however, also easy to turn off. As with billboards, it remains unclear whether health content is reaching its intended audience. On social media, for example, many public health and medical professionals follow CDC on Twitter, but the extent of dissemination to the lay public is unknown. As with all unidirectional public health messaging, it is challenging to accurately assess the effect of such campaigns on health outcomes amidst the many other health influences in the individual’s environment. To measure the effectiveness of public health messages, innovative sampling and methods and proxy outcomes may be needed.

Web-Based Social Media Interventions for Cancer Prevention Behaviors

Social media can also be used as a delivery platform for conducting intervention studies aimed at promoting health and wellness [13,30]. Web-based interventions have significant advantages: cost, ease of participation, and ability to scale up. These interventions can also harness the interaction dynamics of Web-based social networks and create positive peer-to-peer momentum for behavior change. For instance, in the area of smoking cessation, the Tobacco Status Project (TSP) is a Facebook intervention for young adult smokers combining messaging, peer-to-peer interaction, online counseling sessions, and group cognitive-behavioral sessions. A feasibility trial achieved 72% follow-up rates and an 18% rate of reported 7-day abstinence at 12 months (9% verified) [31]. Importantly, engagement in the intervention was high, with 92% participation in the full 3-month intervention [32]. These results demonstrate that Web-based social media platforms can be used to deliver behavioral interventions; however, the content, mode of delivery, and network structure all require careful planning and evaluation [33,34]. A clinical trial testing the efficacy of TSP on biochemically verified smoking abstinence is underway [35]. We believe that conducting interventions via social media platforms requires further study to understand the specific components that contribute to intervention effectiveness, such as the ideal intensity/timing/duration of the intervention, how/which Web-based social networks to access (general social networking vs disease-specific sites), the mix of peer-to-peer versus expert support for behavior change, how to escalate to “real-life” interventions such as pharmacologic treatment for tobacco (eg, nicotine replacement), and how to address Web-based misinformation and foster trust of information.

One of the major challenges in social media research is the rapid pace at which social media platforms evolve online and gain and lose popularity for certain segments of society. For example, Facebook has gained more users in the older age groups and has lost favor with younger age groups who have migrated to other platforms such as Snapchat. Research involving specific social media platforms can quickly become outdated as it can take several years for research studies to be funded, implemented, and ultimately published. This can be a frustrating challenge for researchers engaged in social media and health studies; although there are no easy solutions to this, there are possibilities to reframe the research questions to be more platform-agnostic and thus more widely applicable to the understanding how social media affects health behaviors. A more conceptual approach, driven by conceptual frameworks, to the research question can shed insights on constructs underlying social interactions that influence health behavior, as opposed to relying on specific platform. In considering the choice of platforms, researchers should prepare to be nimble and course-correct if they realize that the target audience or research question does not match the intended platform. Funded research should consider alternate platforms as part their research strategy and anticipate potential problems and alternative solutions to meet the needs of the research question.

Although social media interventions have the significant advantage of reaching people where they are, more complex health behaviors such as quitting smoking may require more intensive interventions beyond online social interactions. For instance, replacing in-person tobacco cessation counseling with online counseling allows participants to receive content without consuming transportation time, and at their convenience; however, there is a concern that delivering interventions online may dilute their effectiveness, especially because of the lack of personal connection. Moreover, many evidence-based interventions developed to be delivered in-person or via telephone require significant adaptation for Web-based social media [33], and reach, efficacy, and implementation may differ significantly. Future studies should incorporate rigorous methodological approaches in the design and evaluation of social media interventions by drawing on appropriate conceptual frameworks and evaluation methods from implementation sciences [36] regardless of whether they are newly developed or are adopted from existing interventions, because the “rules of engagement” online are so different from traditional health intervention environments.

Measuring outcomes is a methodological challenge in all types of studies. For social media and health research, there are various ways in which outcome measures can be obtained: (1) enrolling participants online and obtaining informed consent to follow participants for behavior change, (2) partnering with platforms to examine online actions (social media analytics such as click-throughs, page-viewing behaviors, purchases, etc), and (3) partnering with health systems for data linkage and online/clinic-hybrid interventions (linkage with electronic health records). These approaches combine traditional research methods of data collection (ie, direct data collection from participants through surveys) with innovative partnerships with social media platforms and health systems to provide a more comprehensive collection of outcome data to ascertain intervention effectiveness.



In this new era of communication, social media has tremendous potential to improve public health as it has permeated society across all socioeconomic strata and races/ethnicities [37]. Young adults comprise a diverse population on social media, which has implications for addressing future disparities in cancer. The range of research described in this viewpoint paper harnesses a variety of disciplines, ranging from data science to social science. There is a need to ensure that multidisciplinary research teams have the appropriate expertise to conduct the research; the team’s composition should be driven by the expertise needed for the proposed research questions (data science, disease-specific/clinical expertise, behavioral science, communication sciences, public health professionals, social marketing experts, and qualitative and quantitative methods). Furthermore, research is needed to understand the effects as well as risks of using social media for cancer prevention in young adults to determine the impact on reducing the future burden of cancer. Use of social media as a health promotion tool seems most relevant to modifiable behavioral risk factors in young adults and warrants further research to prevent cancer in the next generation.

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Want to score on social, pharma? Follow Sanofi's lead, experts say | FiercePharma



Sanofi could have just let it go. When actress Roseanne Barr blamed its sleep aid Ambien for a racist post, the pharma company could have simply ignored it and let the Twitterverse call out the inaccuracy. Instead, Sanofi seized the moment and responded with a pithy, yet relevant and product-accurate tweet response that wryly noted: “While all pharmaceutical treatments have side effects, racism is not a known side effect of any Sanofi medication.”

That sort of real-time social media response isn't easy to pull off effectively. Consumer brands like Moon Pie, Wendy's and Oreo do it regularly, but there are also plenty of big brand social media flops to make companies think twice about going for the clever retort.


Which makes Sanofi’s leap even more significant: It's a regulated pharma company that has to send its messaging through compliance reviews. But Sanofi’s U.S. communication team moved fast enough to write, vet and post the response within hours of the original tweet, stepping into the cultural conversation as it happened.


Social media experts applauded and consumers responded—the post has been retweeted 68,800 times and liked by 186,000 accounts. It also garnered more than 6,100 comments with many people replying  “thank you,” “well done” or posting congratulatory memes. The previous top performing post from @SanofiUS garnered 78 retweets and 241 likes.


Pharma marketing insiders, meanwhile, praised Sanofi for its message, timing and boost to pharma social media credibility overall.

Julie Hurvitz Aliaga, vice president of social media at CMI/Compas said via email, “They tackled it before it had an opportunity to be an issue, educated about their drug and what it does not do, and won praise for doing so—as being a company who is not going to sit back and watch—but take action to educate.”

The balance of humor and seriousness was important, noted Klick Health’s senior director of social practice Brad Einarsen in a blog post: “The dry wit that infuses the tweet itself is fantastically balanced. There are many very serious issues surrounding these events, and we cannot lose sight of that, but the understated facts really pull off the corporate message and provide just the right amount of spark for others on Twitter to carry it along.”


RELATED: Pharma's social media strategies are growing up—and working better, too, report finds

Wendy Blackburn, vice president at healthcare and pharma agency Intouch Solutions, added her own kudos and hope for the industry: “Good for Sanofi for standing up and speaking out. I applaud their ability to react with swift action. Done the right way, we’d all like to see more of this from pharma.”

For pharma companies that might be interested in doing that, she offered a few tips. Companies should listen especially for well-known people or celebrity mentions of their brands because whether positive or negative, those get a lot of attention on social media. She also advised setting up an action plan so that the company can act quickly in those moments. And finally, just do it.

“Respond as immediately as possible. Current events move too quickly. Tomorrow is too late,” Blackburn said.

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Is Social Media Changing the Doctor-Patient Relationship?  #esante #hcsmeufr #digitalhealth


Results from two recent surveys reaffirm longstanding trends in the ways patients of different ages use social media and the internet to access health information and communicate with physicians. The surveys' findings also illustrate the growing importance of social media in the doctor-patient relationship and underscore the communication challenges family physicians face while trying to meet the needs of a diverse patient base.

Social Media: To Friend or Not to Friend?

The first survey,( conducted on behalf of the American Osteopathic Association (AOA), asked questions about social media use and the sharing of health information. Of the 2,204 U.S. adults surveyed, 551 were ages 18 to 34 and were categorized as millennials by the AOA.

Among the results:

  • 54 percent of millennials and 42 percent of all adults either are or would like to be friends with or follow their health care professional on social media.
  • 65 percent of millennials and 43 percent of all adults think it is appropriate to use social media to contact their physician about a health issue, either by posting a message on the physician's web page or via direct message.
  • 32 percent of those surveyed have taken a health-related action such as modifying their diet, taking a dietary supplement, changing their exercise routine or trying an alternative treatment based on information they read on social media. (The survey did not indicate whether adults consulted with their physician before taking a health action.)
  • 15 percent of parents with children younger than 18 have self-diagnosed a health concern based on information they read on social media.
  • Results from two surveys show the effects of social media and the internet on the ways patients of different ages choose to access health information and communicate with their physicians. 
  • Younger patients appear to be more comfortable communicating with their physician directly on social media and looking up health information online.
  • Many older patients seem to be more comfortable speaking with their physician by phone, although some also use online patient portals to communicate and for other services.

Communication and Access

The second survey,( part of the National Poll on Healthy Aging, asked a group of 2,013 older adults ages 50 to 80 about their experiences using secure online patient portals to obtain and exchange health information.

Among the findings:

  • Only 51 percent of those surveyed have actually set up an account on a patient portal. Higher rates were seen in women (56 percent compared to 45 percent for men) and adults with more education (59 percent for those with some college versus 40 percent for those who graduated from high school only).
  • When asked why they had not set up a patient portal account, 40 percent of respondents said they did not like communicating about their health by computer; 38 percent didn't think it was necessary to set up a portal account; and 26 percent said they were not comfortable with technology.
  • Among those who had set up an online portal account, 84 percent used it to view test results, 43 percent used it to refill a prescription, 37 percent used it to schedule an appointment, and 26 percent used it to get advice about a health problem.

Although online portals may solve some communication issues, many older adults appear to be more comfortable contacting their physician's office and speaking with the physician or a staff member. Poll results showed that under some circumstances, older patients thought that talking by phone was more effective than using a patient portal.


  • 47 percent of patients rated the phone as a better way of communicating in terms of having the ability to explain their request to a health care professional, compared to 21 percent who rated the portal as better.
  • 36 percent of patients said the phone is better with regard to how long it takes to get a response, compared to 34 percent for the portal.
  • 30 percent of patients rated the portal as better in helping them understand the information received from their health care professional, compared to 27 percent who said the phone was better and 43 percent who rated them as about the same.

In addition, some adults who had not set up a patient portal account cited specific concerns about doing so:

  • 26 percent reported being very concerned about a greater chance of error with a portal compared with talking to a health care professional in person or by phone.
  • 18 percent were very concerned that they would not know who was answering their questions.
  • 16 percent were very concerned that it would take a long time to receive a response.

"Many older adults still prefer telephone contact with their providers," explained Preeti Malani, M.D.,( a professor of medicine at the University of Michigan in Ann Arbor and the poll's director. "We hope providers, and health systems, will take these findings into consideration when designing the ways patients can interact with them," she told HealthDay News.

Putting Online Communication in Perspective

Although people who use social media to speak with their physician or obtain health information make up only a fraction of the total number of people who use social media, it's important to see how those numbers stack up with the general population.

According to the Pew Research Center's Social Media Use in 2018 survey,( 88 percent of American adults ages 18 to 29 use some form of social media. That share drops with age, falling to 78 percent among adults 30 to 49, 64 percent among those 50 to 64, and 37 percent among those 65 and older. The most popular platforms among all adults are YouTube (73 percent) and Facebook (68 percent). However, more than half of young adults also use Snapchat and Instagram (68 percent and 64 percent, respectively).

In many instances, people are accessing social media throughout the day. Seventy-four percent of Facebook users, 63 percent of Snapchat users and 60 percent of Instagram users visit those sites one or more times per day.

And people aren't restricting their social media use to just one platform. The survey found considerable overlap between users of different services. For example, the survey results showed that 87 percent of people who use Facebook also use YouTube, and 90 percent of people with a LinkedIn account also use Facebook. As with overall use, the average number of social media platforms used was highest among adults 18 to 29 (four), decreasing to three platforms among adults 30 to 49, two among those 50 to 64, and one among those 65 and older.

How Family Physicians Are Meeting the Challenge

Family medicine is sometimes referred to as a "cradle-to-grave" specialty. At a given moment, the typical family physician's waiting room may contain patients of virtually any age. This diverse mix can make it difficult for FPs to find ways to effectively communicate with their patients on social media without overstepping the bounds of privacy and confidentiality.(  

Fortunately, evidence from the latest AAFP Member Profile(14 MB PDF) suggests that family physicians are already stepping up to meet the challenges in communication that come with treating such a diverse group of patients. Profile survey results indicate that:

  • 69 percent of active AAFP members have a web portal that allows for secure messaging;
  • 57 percent have a web portal for prescription refills;
  • 51 percent communicate with patients via e-mail;
  • 44 percent have a web portal to schedule appointments and share health information; and
  • 12 percent offer direct text communication with patients.

In addition, 20 percent of AAFP members report using telehealth services in their practices. The two main reasons for implementing these services are to improve patients' access to care (78 percent) and to provide more convenience and flexibility for physicians and office staff (61 percent).

Significant numbers of AAFP members also report using a phone or mobile device regularly for direct messaging (81 percent), checking e-mail (78 percent), going online (76 percent), and accessing social media (45 percent).

The Bottom Line

As these surveys show, the way patients and physicians interact has forever changed as increasing numbers of patients communicate using e-mail, a social media platform or a web portal. Younger patients -- in particular, those under 30 -- are far more comfortable texting or e-mailing their physician; they also are more comfortable looking up health information online. Older patients, although willing to use online portals for some services, nevertheless remain satisfied with more traditional methods of communication.

Family physicians are responding to these trends by adjusting their own communication methods to best address the needs of their patients. As patient demographics shift, FPs will want to continue to take these considerations into account and plan their communication and patient outreach strategies accordingly.

Jean-Christophe Lévêque's curator insight, June 12, 2:05 PM

Etude intéressante sur l'impact des Social Médias entre patients et praticiens. Des chiffres plutôt prometteurs sur les intentions, à suivre sur leur réalité opérationnelle. #MBAMCI #hcsmeufr #Esanté

Mining Patients' Narratives in Social Media for Pharmacovigilance: Adverse Effects and Misuse of Methylphenidate #hcsmeufr #esante #digitalhealth cc @evedrug @evepie


Background: The Food and Drug Administration (FDA) in the United States and the European Medicines Agency (EMA) have recognized social media as a new data source to strengthen their activities regarding drug safety.

Objective: Our objective in the ADR-PRISM project was to provide text mining and visualization tools to explore a corpus of posts extracted from social media. We evaluated this approach on a corpus of 21 million posts from five patient forums, and conducted a qualitative analysis of the data available on methylphenidate in this corpus.

Methods: We applied text mining methods based on named entity recognition and relation extraction in the corpus, followed by signal detection using proportional reporting ratio (PRR). We also used topic modeling based on the Correlated Topic Model to obtain the list of the matics in the corpus and classify the messages based on their topics.

Results: We automatically identified 3443 posts about methylphenidate published between 2007 and 2016, among which 61 adverse drug reactions (ADR) were automatically detected. Two pharmacovigilance experts evaluated manually the quality of automatic identification, and a f-measure of 0.57 was reached. Patient's reports were mainly neuro-psychiatric effects. Applying PRR, 67% of the ADRs were signals, including most of the neuro-psychiatric symptoms but also palpitations. Topic modeling showed that the most represented topics were related to Childhood and Treatment initiation, but also Side effects. Cases of misuse were also identified in this corpus, including recreational use and abuse.

Conclusion: Named entity recognition combined with signal detection and topic modeling have demonstrated their complementarity in mining social media data. An in-depth analysis focused on methylphenidate showed that this approach was able to detect potential signals and to provide better understanding of patients' behaviors regarding drugs, including misuse.



Patients use social media to seek information, to receive advice and support from other Internet users in order to better manage their own health care and improve their quality of life (Lamas et al., 2016). Patients and their family share information about drugs in social media; they report on the outcomes and the impact of the drugs on their health and day-life; they describe their attitudes toward the drugs, including adherence to the treatment, adverse events and sentiment (Laranjo et al., 2015). Consequently, social media data mining has been recognized by drug agencies as a potential approach to identify patient reporting of adverse drug reactions (ADR), and to analyze the attitudes and knowledge of general public and patients on medicines. The Food and Drug Administration (FDA)1 in the United States and the European Medicines Agency (EMA)2 are considering social media as a new data source to strengthen their surveillance activities. Several authors have compared traditional data sources and social media. They demonstrated similarities between these sources to detect signals about adverse reactions but suggested that social media sources contained different information (such as less serious events and more adverse effects related to their quality of life) and were used by patients. As healthcare professionals mainly report to drug agencies, social media may be a complementary source about drug use and safety. This conclusion was shared by, e.g., Duh et al. who analyzed posts related to atorvastatin, a lipid-lowering agent and sibutramine, an appetite suppressan drug (Duh et al., 2016), and by Pages et al. who focused on oral antineoplastic drugs (Pages et al., 2014). However, we still lack a deep understanding of the characteristics of patient reported information about ADRs and patient attitudes regarding drug therapies, which hinders clear guidance on how to adapt text mining tools for social media and how to use them for decision in public health and drug safety (Golder et al., 2015). Dedicated tools may help experts to extract relevant information from the data available in different sources without spending time to explore manually the data (Lardon et al., 2015Nikfarjam et al., 2015Sloane et al., 2015). Nevertheless, Sarker et al. showed that the most popular algorithms in the published studies were supervised classification techniques to detect posts containing ADR mentions, and lexicon-based approaches to extract named entities from texts (Sarker et al., 2015). We believe that such approach still requires enhancements to support data mining in pharmacovigilance, particularly in making the data generated by patients more prominent, explicit, and accessible to experts in pharmacovigilance. Moreover, data mining should not be limited to ADR detection but rather integrate all kinds of information reported in posts, like patients' attitudes toward the treatment, compliance, and misusage.

The main objectives of the ADR-PRISM project (Bousquet et al., 2017) were to perform text mining and visualization tools to enhance our understanding of patient reported information in social media and to assess how it could be used for pharmacovigilance purpose. In the context of ADR-PRISM, we conducted an in-depth content analysis of the anonymized data publicly available on methylphenidate on five open French patient forums. This study is used in this article to present the methods that we developed to mine social media and to illustrate their results. The research done in the framework of ADR-PRISM has been supported by an Ethics Advisor Board. The Ethics Advisory Board was composed of scientists with different scientific backgrounds: Gaby Danan from Pharmacovigilance Consultancy; Alain-Jacques Valleron from INSERM UMR1169 and Paul-Olivier Gibert from Digital&Ethics, and provided independent advice on the project.

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19 Outstanding Hospital Social Media Teams | Convince & Convert  #hcsmeufr #esante #digitalhealth


In many ways, spearheading social media for a major U.S. hospital is like spearheading social for any brand. Telling stories, engaging an audience, managing community feedback, and analyzing your efforts are part of every social media marketer’s job. Hospital social teams, however, face the unique challenge of operating in a highly regulated industry. Audiences look up to them as community leaders and educators. The patient stories they tell and feedback their receive often carry life-changing consequences.

Social teams at these institutions have to be exceptional listeners and top-notch strategizers. We set out to identify the teams going above and beyond on social media—the truly exceptional in this challenging field. Below you’ll find the 19 best social media teams from the nation’s top hospitals, each one responsible for some of the most successful and engaging social media content in the health industry 

NewYork-Presbyterian Hospital


Emily Berkowitz, Social Media Associate

NewYork-Presbyterian Hospital boasts the most engaging social media presence of any hospital in the U.S., according to our latest research. As Social Media Associate, Emily masterminds NYP’s social strategy and upholds the hospital’s status as a supportive and educational community cornerstone.

Cleveland Clinic


Nada Youssef, Social Media Coordinator


Stephanie Petrucci, Social Media Manager


Shelby Simmons, Social Media Coordinator


Tyler Maddox, Physician Social Media Coordinator


Chandra Lubben, Social Media Coordinator

Cleveland Clinic is lucky enough to have a large team of pros heading up its social media efforts. This stellar team generates twice as much social content as the average U.S. hospital and boasts one of the highest engagement rates in the country.

Mayo Clinic


Audrey Laine Seymour, Social Media Specialist

Rounding out the top three is Mayo Clinic’s Audrey Laine Seymour. Mayo Clinic stands head and shoulders above its peers when it comes to social video content and was responsible for one of the most “Loved” Facebook video posts of any hospital this past February.




Shannon Shields, Social Media Strategist

Shannon has been with the University of Pittsburgh Medical Center since 2015. In her time with UPMC, she’s built one of the most engaging social presences in the hospital industry, reaching audiences on Twitter, Facebook, Instagram, LinkedIn, and—yes—even Pinterest.

IU Health


Daniel Woody, Associate-Senior Social Media Strategist

Daniel took charge of social media at Indiana University Health last year. Like its peers in the top five, IU Health maintains a prolific social presence and attracts a striking amount of engagement.

UCLA Health


Linda Ho, Director, Digital Marketing


Georgiana Masgras, Web & Social Media Strategist


Ashley Anderson-Dinielli, Social Media Manager

The top-notch social media team at UCLA Health places special focus on uniting their institution’s silos under a strong, unified brand voice. According to Digital Marketing Director Linda Ho, they’re devoted to their social media monitoring, which helps them take a proactive approach to engaging with their audience and stay aware of the social conversation surrounding the hospital.

One such proactive strategy is the UCLAMDChat series. This webinar series connects audiences with doctors and medical experts via Facebook Live, YouTube, and Twitter. Viewers tune in to get the latest information on medical advances at UCLA, conditions, and treatments.

Linda offers this advice to social media teams in heavily regulated industries: “Have a process in place to manage content as well as content contributors. Be patient as you work towards establishing a formal policy towards achieving your goals.”

Johns Hopkins Medicine


Elena Meadowcroft, Web Content Specialist


Breana Fischer, Internet Marketing Specialist

Elena and Breana both joined Johns Hopkins in 2016. In addition to running the hospital’s social presence, the team also maintains a successful email marketing strategy with a robust subscriber base.

UCSF Medical Center


Marc Fredson, Director, Strategic Marketing


Diana Silva, Associate Director, Digital Marketing Projects


Rob Odom, Vice President, Marketing and Brand Management


Sarah (Chan) Fan, Marketing Manager


Jeanne Zielinski, Marketing Manager

The social team at UCSF Medical Center caught our eye when they turned a Facebook link post—usually one of the worst-performing types of social content—into a major point of engagement. Rather than let comments simply accumulate on their announcement post, the UCSF team personally thanked every well-wisher.

Massachusetts General Hospital


Monique Tremblay, Digital and Social Marketing Manager

Since 2016, Monique has spearheaded Massachusetts General Hospital’s social strategy and even worked with local colleges to show students what hospitals are doing in digital marketing.

Mount Sinai Health System


Kavya Rathi, Communications and Marketing Associate


Danielle O’Malley, Assistant Director of Marketing


Courtney Seck, Marketing Manager


Christine Chung, Digital Marketing Manager

Rounding out the top ten is the team at Mount Sinai, serving the New York City community.



Katie Rosenblum, Digital Specialist, Social Media


Agata Smieciuszewski, Social Media Coordinator


Carrie Yutzy, Associate Director, Digital Strategy

Cedars-Sinai’s growing social media team engages its audience and manages community feedback across Facebook, Twitter, and Instagram.

Vanderbilt University Medical Center


Blake Stuck, Social Media Coordinator


Francesca M. Rutherford, Access Specialist

This small team does it all for the Vanderbilt community: brand management, blogging, analysis, social, and more.

Memorial Hermann


Princess Nwaohuocha, Social Media Specialist


John Dabkowski, Marketing Manager


Ali Vise, Digital Marketing, Social Media, and Communications

The powerhouse team at Memorial Hermann serves their Houston community across Facebook, Twitter, Instagram, and LinkedIn.

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Patient engagement or social media marketing?  #hcsmeufr #esante #digitalhealth


The rising use of social media creates an obvious opportunity for certain parties, such as pharmaceutical companies, to engage with the public in new ways.

Advocates of pharmaceutical companies reaching out to potential customers online suggest the industry has been too reluctant to invest heavily in social media strategies, mainly because of a vague regulatory environment. But skeptics of the practice say the pharmaceutical industry is already gung ho about social media, which some companies appear to be using to circumvent restrictions on direct-to-consumer advertising, a practice legal in only the United States and New Zealand.

In a recent report called “Engaging patients through social media,” the IMS Institute for Healthcare Informatics states that “the strategies that pharmaceutical companies use to engage with social media could be categorized as low-risk and less innovative than those employed in other industries.”

The report notes that use of social media among US adults has grown from 8% in 2005 to 72% by 2013, and that Facebook is the fourth most popular source of health information in the United Kingdom. These numbers are sure to increase, the report suggests, as so-called digital natives — those as comfortable texting and tweeting as they are walking and breathing — grow into adulthood and become more concerned about their health.

Yet the pharmaceutical industry has been slow to embrace social media, claims the IMS Institute, a company based in Danbury, Connecticut. One reason is the lack of guidance from health regulators — in the US, Canada and Europe — about using social media. In the US, for example, the only restriction seems to be on the promotion of off-label uses of drugs. Some companies may be reluctant to invest heavily in a social media strategy for fear of wasting time and resources should strict regulations come into force.

The rising use of social media creates an obvious opportunity for certain parties, such as pharmaceutical companies, to engage with the public in new ways.

Image courtesy of MicroWorks/Thinkstock

Other concerns include how — or whether — to handle claims of adverse events received through social media and how to measure return on investment. New strategies would also be required to respond much more quickly to consumer concerns. A slow response can escalate into a public-relations nightmare with tweets, Tumblr and Facebook comments going viral in hours.

“Users of social media now expect to be able to have a conversation with pharmaceutical companies when they face uncertainties,” states the report. “If there is no conversation, or only a standardized answer, it could lead to frustration and be of little overall benefit to both involved parties.”

But what does engaging patients really mean in this context? “When you talk about engagement, it is really about direct marketing to the consumer,” says Timothy Mackey, an investigator for the San Diego Center for Patient Safety at the University of California San Diego.

In a 2011 paper entitled “Prevalence and global health implications of social media in direct-to-consumer drug advertising,” Mackey and colleagues looked at the social media presence of the 10 largest global pharmaceutical corporations. All were active on Facebook, Twitter, sponsored blogs and other social media platforms, and 80% had YouTube channels. Many individual drugs also had dedicated Facebook pages and Twitter feeds.

This has led to a new form of direct-to-consumer advertising, developed for interactive social media, which the researchers have dubbed eDTCA 2.0. Though some of these websites state they are intended solely for US residents, the Internet transcends borders. These websites don’t appear to restrict access to web users from outside the US, Mackey and colleagues note in their paper.

“The new consumer is one that is global and connected online, a profile that precisely fits the patient/consumer of eDTCA 2.0,” the paper states. “Public health policy must take into account this new consumer and the rapidly developing digital environment.”

Some websites set up by drug companies (and medical-device manufacturers) to create communities of potential consumers have scant corporate branding and appear to exist primarily to offer free services. These sites, called patient-engagement portals, might offer guidance on how to manage a particular medical problem, such as high blood pressure. They may offer risk assessment tools for sleep apnea or any number of conditions. Some even offer online patient coaches.

“What they are really doing is engaging directly with patients and collecting consumer information, which they may or may not categorize as PHI, or protected health information,” says Mackey. “It’s about getting information directly from the consumer, mining data and using that for their own marketing purposes. That’s why these websites exist.”

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101 Healthcare Hashtags to Target Doctors & Patients on Social Media  #hcsmeufr #esante #digitalhealth


80 Healthcare Hashtags to Build Your Social Media Following


Add healthcare and medical hashtags to your social media posts to target discrete niches of consumers and doctors. They’re also helpful for finding other people and influencers that share your interests.

Better know your healthcare hashtags

Hashtags are words inserted into social media posts preceded by the pound sign. On platforms like Facebook, Twitter, Instagram and YouTube, they’ll help you target communities interested in your brand.

Click a hashtag, and it will summon all the posts throughout Twitter that use the same identifier. You can also search social platforms for specific hashtags. For example, search for #lupus to view all the posts on the topic.

Search #mhealth, a very popular hashtag, and see what pops up.

The marketing benefits

  1. Build your audience outside of your current following. One retweet from the right person may reach thousands of additional accounts.
  2. Refine messages for your audience. Users who search for a hashtag are engaged and actively looking for a solution or information you can provide. For example, many medical device manufacturers want to target multiple audiences with a single feed.
  3. Cement your branding. You are your content, and tagging your posts can proclaim your expertise to doctors, patients and their influencers.
  4. Almost free. Once you develop a list of popular hashtags for your social media posts, tagging them is only a few more keystrokes.
  5. Geo-targeting is crucial for hospitals, and others providing services to patients. Patients in Bismark won’t benefit from your Tweets from your Brooklyn ASC.

SC. Solve by adding a hashtag that defines the geographic location of a hospital or practice. #Bariatric #Cincinnati. Easy!

Where do I find hashtags?

Get started by selecting from the healthcare hashtags below. The online tools below will help you match the right hashtags to your brand.

Find new hashtags research tools at

Hashtag Research Tools for Instagram

Incorporating Hashtags in Your LinkedIn Articles

Top hashtags for Hospitals

Common healthcare tags

#FOAMed (Free open access meducaton)
#mhealth (mobile health)
#hcsm (healthcare social media)
#MedEd (Medical Education)
#doctors20 (How Doctors are Usng Social Media and Web 2.0 Tools)
#HCR (Health Care Reform)
#Hitsm (Health Care IT Social Media)
New hospital hashtags sprout up like weeds. The list below is merely a snapshot. Every disease, condition and specialty is a potential hashtag.

Tags for medical devices

There are no rules, but a best practice is to tag the specialty or subspecialty your targeting and the product category, for example, “We found a bobblehead doll in the patient’s abdomen #ultrasound #ER”
This example features a product that could be used in a number of different settings, so write multiple tweets and tag them for other specialties.

Target Diseases and Conditions

Illness hashtags aboud, too. For targeting purposes, notice the difference between the terms used by patients and doctors. Long, scientific tags are generally not for consumer use, but they’re a strong signal to physicians or other medical professionals. Patients may seek suggestions for car and/or use their symptoms in a hashtag.


The Twitterverse is huge but tagging your posts can shrink it down to a narrower target audience of a manageable size. Sign up for BioNews to learn more about healthcare social media.
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Medical Marketing: how to properly disclose social media endorsement according to the Federal Trade Commission Guideline #esante #hcsmeufr


When thinking about transparency, those of us at a certain age will probably reminisce about the clear sheets of paper used for projector demonstrations your teacher drew on during high school biology class. Others may correlate transparency to the demanding call-to-action in the aftermath of the Enron scandal or Trump’s refusal to release his tax returns during his Presidential bid in 2016. Transparency is a word tossed around (usually in a post-corporate scandal cleanup) in most major industries—banking, real estate, and government. The healthcare industry is not dissimilar. Politicians call for transparency for drug pricing, consumers call for government accountability on healthcare coverage, and the FTC seeks transparency from healthcare marketers promoting their products to the public.

Many advertisers rely on the influence of celebrities, medical professionals and satisfied patients to positively impact the perception and sales of their brand’s product. With the increased focus on impacting patient behavior, especially through personalized product endorsements, healthcare marketers must adhere to transparent, ethical methods of providing education to consumers. As medical marketers navigate social media, they must balance a new world of effective influencer marketing with increasingly well-regulated government guidelines.


The basic premise of the FTC’s “Guides Concerning the Use of Endorsements and Testimonials in Advertising” is that, if there exists a material connection between the influencer who is endorsing the product and the company that is marketing the product (e.g., a payment, a free product sample or procedure, a family connection, etc.), that connection must be disclosed.

The FTC provides guidelines for the use of promotional endorsements and testimonials and has in recent years clarified their stance to encompass social media promotion. The FTC offers a number of guidelines that brands can follow to convey a reasonable degree of transparency to digital media/social media consumers.


The FTC recognizes the difference between paid endorsements and unsolicited content created by a product user. For example, RealSelf, a thriving community of individuals who share their experiences with particular products, procedures and physicians within the aesthetic beauty industry, is a perfect example of unsolicited consumer-generated content. When engaging in a paid or endorsement-related relationship with a brand ambassador or influencer, the FTC outlines the following key guidance:

    • Endorsements must reflect the honest opinions, findings, beliefs, or experience of the endorser. Furthermore, an endorsement may not convey any express or implied representation that would be deceptive if made directly by the advertiser.
    • The endorsement message need not be phrased in the exact words of the endorser, unless the advertisement affirmatively so represents. However, the endorsement may not be presented out of context or reworded so as to distort in any way the endorser's opinion or experience with the product.
    • When the advertisement represents that the endorser uses the endorsed product, the endorser must have been a bona fide user of it at the time the endorsement was given.
    • Any material connection between the advertiser and endorser must be disclosed.
    • Advertisers must balance any consumer endorsement with "competent and reliable scientific evidence" as well as "conspicuously disclose the generally expected performance" of the endorsed product.

Based on FTC research, even a consumer testimonial with the disclaimers of “results not typical” or “testimonials are based on the experiences of a few people and are not likely to have similar results” do not sway an audience from taking the claims as usual or typical. A strong disclaimer could be effective, and the impression left with the audience non-deceptive, however… do you really want to tempt the FTC these days?


In keeping with the digital times and the constantly morphing use of social media as a viable healthcare marketing tool, the FTC released an April 2017 letter to over 90 influencers and marketers reminding them to:

    • Conspicuously disclose their relationships to brands when promoting or endorsing products through social media.

If the connection is not adequately disclosed, consumers might give the endorsement more credence than they would have given it otherwise, and the endorsement is considered by the FTC to be a deceptive business practice in violation of Section 5(a) of the Federal Trade Commission Act.

    • Disclose their material connection in "unambiguous language" and make the disclosure "stand out".

Because of the recent crackdowns on Instagram sponsorships, many influencers on the platform are becoming even more conservative with disclosing brand partnerships—even those that are unpaid. Sponsored promotions can no longer rely on unclear or cryptic language or hashtags to legitimize a product endorsement. For example #sp, #partner or "Thanks [brand]" are not sufficient to express the post is sponsored. On Instagram in particular, many brand ambassadors are adding the word "sponsored" and/or their brand partners name front and center where a location tag would normally go.

    • Ensure that the disclosure of an endorsement is readily visible and not hidden below a "More" button, particularly on Instagram.

Consumers viewing Instagram posts on mobile devices typically see only the first three lines of a longer post unless they click "more," which many may not do. The FTC goes on to clarify that hashtags delineating sponsored posts cannot be hidden in the midst of 20 other hashtags but must be easy to identify. Similarly, sponsored Instagram Stories must include a superimposed disclosure that is easy to notice and readable within the timeframe (or length) of the story, and cannot be hidden within other hashtags or text.


Patient testimonials and endorsements on social media can be incredibly helpful to you and your brand. This is especially true if the patient is writing about how much they like something they bought on their own and they are not being rewarded. Consumers have many opinions and personal experiences with a product or brand. Depending on the circumstance a marketer should not shy away from social engagement with a “thank you” response or an acknowledgment of the patient experience. We recommend not engaging with Internet trolls or bots. However, if the patient is writing that review as part of a sponsored campaign or are being compensated in any way—for example, getting a discount on a future purchase or being entered into a sweepstakes for a significant prize—then a disclosure is not only appropriate, it is imperative. 

We recommend fostering online relationships with those who are the most vocal of your users or patients. With proper engagement those individuals can become an additional source of information to potential patients and consumers. People trust peers more than brands and there is value in influencers extoling your product or procedure to ring loud. Be sure there is always transparency surrounding the relationship by including visible disclaimer language. 

Social media is rapidly changing and keeping up with the rules and regulations can feel like a full-time job—but in healthcare we’re used to that! Hopefully, the recommendations in this blog will help you navigate FTC guidelines—in addition to Regulatory guidelines—on social media for your life sciences brand. With the right attitude and clearly defined relationships about the content you’re publishing on your channels, social media’s benefits can hugely outweigh the risks.

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Future of Cardiology Will Be Defined by Digital, Mobile Advances #esante #hcsmeufr


Three JACC articles examine how new technology will change the prevention and treatment of heart disease
Art Jones's curator insight, June 6, 3:22 PM

Excerpt: The future of cardiovascular care will be transformed by advances in artificial intelligence, digital health technology and mobile devices as a means to prevent and treat heart disease

Richard Platt's curator insight, June 8, 10:56 PM

The Use of Artificial Intelligence in Cardiology:  As the type and breadth of data available to cardiologists and the cardiovascular care team continues to grow more sophisticated, physicians are increasingly being asked to provide more rapid and personalized interpretations of data to their patients. One solution to providing this level of personalized medicine efficiently is artificial intelligence, also known as machine learning. researchers analyze select applications of artificial intelligence in cardiology and identify how the specialty could incorporate more artificial intelligence in the future to enhance the capabilities and experiences of clinicians and patients.  “(Artificial intelligence) has clear potential to enhance every stage of patient care — from research and discovery, to diagnosis, to selection of therapy,” said Joel Dudley, Ph.D., senior author of the review and director of the Next Generation Healthcare Institute at Mount Sinai. “A key next step to incorporating artificial intelligence into cardiology is to align available data and technologies with clinical and business use. This way, we can prioritize short-term opportunities and understand gaps in available data or algorithms that are holding back applications of artificial intelligence in areas of high clinical need.”  According to the review, artificial intelligence is currently only performed by those with specialized training, but in the future, these methods will be increasingly easy and widely available. It may eventually be incorporated into day-to-day practice by interacting with electronic health records and billing.

Seven Steps for Managing Adverse Events in Social Media


In an ever-changing pharma environment staying connected is vital. Amidst regulatory challenges and uncertainty of new channels, the pharma industry is beginning to embrace social media to empower patients and healthcare providers. Social platforms are uniquely designed to support patient and provider needs perhaps more directly and efficiently than traditional channels. Social technologies can be leveraged to support patient engagement, ultimately leading to healthier patient outcomes.



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How does influencer marketing work in healthcare?  #hcsmeufr #esante #digitalhealth


In the Healthlink Dimensions Annual Healthcare Professional Survey for 2018, 28.6 percent of respondents said they used social networking sites to communicate with other physicians and healthcare professionals.

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Survey: Patients want to 'friend' their physicians on social media  #esante #hcsmeufr #digitalhealth


In today’s connected world, we follow everyone on social media—from family and friends to total strangers. But what about your physician and other health care providers?

A new survey from the American Osteopathic Association finds more than half of millennials (54%) and more than four out of 10 (42%) adults are or would like to be friends with or follow their health care providers on social media. The online survey was conducted by The Harris Poll in April 2018 on behalf of the AOA.

The survey also found nearly two thirds of millennials (65%) and 43 percent of all adults feel it is appropriate to contact their physician(s) about a health issue through social media either by posting on their page or direct messaging them. Doctors, however, are still navigating how to manage the patient relationship on Facebook, Twitter, Instagram and other social media platforms that are traditionally designed for sharing content that is not private or sensitive.

“Please don’t send me a picture of your rash on Facebook Messenger,” says Jennifer Caudle, DO, an osteopathic family physician and associate professor at the Rowan University School of Osteopathic Medicine. “I want to be an active part of my patient’s care, but social media does open up opportunities for over-sharing or providing information that would be best managed in the office setting or through designated telemedical technology,” says Dr. Caudle, who has built a vast social media following and is a regular television guest on health matters.

“I want to be an active part of my patient’s care, but social media does open up opportunities for over-sharing or providing information that would be best managed in the office setting or through designated telemedical technology.”

Health professionals are broadly prohibited from communication over social media if any information shared could be used to identify a patient. Over the past few years, the Department of Health and Human Services has instituted numerous policies and standards to guide practitioners who use social media.

Still, some physicians find social media to be an effective tool for sharing important medical information.

“People—and young people in particular—don’t go to the doctor as often as they should but they are interested in improving their health and wellness,” says Mikhail Varshavski, DO, an osteopathic family physician in New York City who is the most “followed” doctor on social media. “If I can inspire a positive lifestyle change in someone through YouTube, then I’ve been an effective physician.”

Better known as ‘Doctor Mike,’ Dr. Varshavski reaches millions weekly through his popular YouTube channel, as well as a Twitter, Instagram and Facebook accounts. He believes that social media is breaking down communication barriers that previously existed in health care, and driving the wellness conversation around important topics including burnout, addiction, nutrition and mental health.

Meeting patients where they are

Dr. Varshavski’s approach aligns with the third survey finding: Nearly one-third of Americans (32%) have taken an action related to their health (e.g., changed diet, exercise or medication, taken supplements or tried an alternative treatment such as acupuncture), as a result of information they read on social media. Moreover, 15 percent of parents of kids under 18 have self-diagnosed a health concern as a result of information they read on social media.

“As an osteopathic physician, I went into this field to make differences in lives by not only treating disease but also through education and prevention,” says Dr. Varshavski. “Social media is a tool doctors can use to continue this mission, one that can influence the health decisions of millions,” he continued.

While health information sourced from social media has been shown to help patients make better informed decisions, people must be certain they are seeking out credible sources and limiting consumption if it’s causing anxiety, cautions Dr. Caudle. Research has found “health anxious” individuals may not benefit from increased access to online health information, forums and ‘Dr. Google,’ which can generate anxiety and may even influence a patient’s perceptions of their symptoms.

“Social media and other digital platforms hold great promise for improving health outcomes,” says Dr. Caudle, “but the conversation should start in the doctor’s office—and in some cases remain there.”

According to Pew Research, 69 percent of the U.S. public uses some type of social media. Among 18-29 year-olds, that number is 88 percent. Forty percent of people ages 18-24 do not see a medical professional annually.

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 Social Medicine: Twitter in Healthcare #esante #hcsmeufr #digitalhealth #socmed



Social media enables the public sharing of information. With the recent emphasis on transparency and the open sharing of information between doctors and patients, the intersection of social media and healthcare is of particular interest. Twitter is currently the most popular form of social media used for healthcare communication; here, we examine the use of Twitter in medicine and specifically explore in what capacity using Twitter to share information on treatments and research has the potential to improve care. The sharing of information on Twitter can create a communicative and collaborative atmosphere for patients, physicians, and researchers and even improve quality of care. However, risks involved with using Twitter for healthcare discourse include high rates of misinformation, difficulties in verifying the credibility of sources, overwhelmingly high volumes of information available on Twitter, concerns about professionalism, and the opportunity cost of using physician time. Ultimately, the use of Twitter in healthcare can allow patients, healthcare professionals, and researchers to be more informed, but specific guidelines for appropriate use are necessary.
 social media; Twitter; communication; patient–physician relationships; technology; public health

1. Introduction

Social media enables the public sharing of information between anyone with an account. While previously used primarily to connect public figures such as politicians, celebrities, and athletes with the general public, additional uses of social media have arisen. Calls to improve the alienating and inaccessible language of healthcare in order to improve patient–physician communication are not unique, and continue to plague medicine [1]. Thus, improving the transparency and accessibility of information in medicine is critical. Since social media allows for the sharing of information, applications of social media to medicine have recently garnered a great deal of attention [2]. Currently, Twitter is the most popular form of social media used for healthcare communication [3].
Conflicting opinions have stirred controversy about if and how medical professionals should use social media platforms in their work. Skeptics of social media in healthcare cite the potential for misinformation, conflicting advice, and unprofessionalism as evidence that social media is not an appropriate medium on which to share healthcare information [4]. Some argue that social media has no place in healthcare, while others claim that the open sharing of information enabled by social media would revolutionize accessibility to medicine. Here, we examine the use of Twitter in medicine and pose the question: “In what capacity should Twitter be used for the sharing of information in healthcare?”
To answer this question and analyze uses of social media in medicine, we first examine how medical professionals have used digital media in the past. Then, we compare Twitter’s features to prior media to investigate how Twitter is currently being used in medicine. From its current uses, we derive its limitations and potential for growth; finally, these limitations guide proposed solutions about how to effectively leverage Twitter in medicine. Ultimately, a review of the relevant literature demonstrates that the use of Twitter to share information about treatments and research among physicians has the potential to greatly improve care. However, when used inappropriately (e.g., for direct public interactions between patients and doctors), Twitter’s privacy and misinformation concerns outweigh the benefit of accessibility.

2. The History of Digital Media and Healthcare

Previous uses of digital media provide necessary context for the current intersection of social media and medicine. The use of digital media in medicine is non-unique, as Dr. Gerald Weissman discusses in his book about medicine in the age of digitization. “Digital medicine” began in the early 2000s, immediately following the widespread popularization of cable television and the Internet [5]. For example, shows on television, such as The Dr. Oz Show and Sanjay Gupta’s various programs on CNN, gained large followings.
Dr. Mehmet Oz, a cardiothoracic surgeon at Columbia University, gained an enormous following by touting a new age of accessible medicine and advocating for alternative medicine, despite dubious scientific backing [6]. Oz shattered the predominant public perception of the time of a distant, intimidating doctor. Instead, the most famous doctor in America had personality and a show which closely resembled Oprah’s. However, Oz often sacrificed rigorous medical support, with only 46% of his claims in a sample of 400 shows supported by medical fact and over 15% contradicting mainstream medical beliefs, according to a study of Oz’s shows by Dr. Christina Korownyk at the University of Alberta [6]. However, the credibility and rapport he developed with his audience caused his “miracle pills” and other dubious advice to gain a following.
Of course, many asked why a reputable doctor who clearly understood appropriate medical practice would resort to recommending such treatments. The answer lies in digital media—for a television audience, “miracle weight loss pills” earned far more ratings than recommendations to eat healthier and exercise regularly [6,7]. While other doctors, like Sanjay Gupta, a neurosurgeon and CNN’s Chief Medical Correspondent, strove to maintain medical accuracy on television, the lack of sensationalized solutions and highly technical jargon limited popularity and viewership [6]. Even WebMD, the highest-trafficked website for healthcare online, has received much criticism for often providing more detailed information supporting drugs made by pharmaceutical companies who sponsor the website [5].
The superficiality of digital media affects the information conveyed on the media itself. For instance, in order to be a successful and profitable television show, Dr. Oz compromised medical accuracy. Thus, misinformation plagues digital medicine, as solutions to health problems are not always simple and facile [6,8]. Superficial explanations and recommendations can lead to unrealistic expectations placed on physicians and strain the doctor–patient relationship [1]. This inability to maintain both correct medical information and sustained viewership is a systematic problem in using traditional digital media platforms for medicine [8].
Despite high rates of misinformation, the increased accessibility of medicine on digital media has the potential to improve patient care and change the perception of medicine as cryptic or esoteric. This accessibility is extremely desirable in medicine, as highly technical terminology can alienate patients and detract from their care [1,9]. Thus, digital medicine in the age of television and early Internet introduced the dilemma of balancing accuracy and popularity, but made medicine much more accessible and could reduce the power imbalance that often exists between the healthcare provider and patient.

3. The Benefits of Twitter in Medicine

Despite clear flaws, many researchers extol digital media as a promising tool to involve patients more in their care and remove barriers to understanding medical treatment [1]. While television allows for many viewers to tune in to a medical professional on a show, the viewer involvement is passive, and only a few sources of information exist [5]. Social media, and particularly Twitter, has fundamentally different functionalities than television by greatly increasing the number of people who can contribute to discourse; anyone with a Twitter account can post public messages of 280 characters or less. Rather than information coming from a limited number of sources which must maintain viewership to stay on air, Twitter allows any medical expert to share their expertise by making an account [10]. Many accounts can provide medical information, while there can only be a certain number of medical shows on television. A recent study verified over 2000 doctors on Twitter based on their National Provider Identifier. These doctors all tweet more than once per day and have at least 300 followers each [10].
The first reason why Twitter has increased in popularity in medicine is that Twitter allows medical professionals to reach a broad audience ranging from other physicians to trainees to patients [4,7]. Anyone with a Twitter account can access the information. Moreover, on Twitter, the consumers of the information are no longer passive, as they can directly reply to tweets or endorse them with “favorites” or “retweets” [10]. Users can now use replies, retweets, and favorites to show which tweets that they view as useful and accurate. These reactions both tell medical professionals what content generates the most reaction and other users what content might be trustworthy. Even more, for each tweet, “hashtags” denote a topic around which users focus their discussions, which promotes communities and groups of tweets about the same disease or question types [2].
Many medical professionals use Twitter for its potential to share and advance biomedical research. By allowing fellow researchers and physicians to connect and share research about new treatments, clinical problems that require further study, or interesting case studies, as seen in Figure 1.
Figure 1. An example tweet from Dr. Rahmi Oklu, an interventional radiologist, on Twitter, in which he shares an interesting case study with patient data correctly anonymized.
Reducing barriers to collaboration in medicine is extremely valuable, as frequent constructive collaboration (i.e., more often and accessible than annual meetings) can greatly improve treatments and may range across disciplines into fields such as computer science and bioengineering [11]. For research articles, Twitter can also serve as a vetting arena for publications as tweets frequently provide critical commentary and opinions about newly published research. Tweeting about an article is much more feasible for researchers than commenting on the article website or crafting commentaries for publication.
Not only can Twitter connect biomedical researchers, it also serves to make research advances more accessible for physicians. Connecting researchers and clinicians is extremely important and useful, as clinicians can use new information they discover from this closer contact with researchers to guide decision-making about patient treatments in an ever-evolving field. Moreover, this exchange of clinical problems and new research can spur research in impactful and unique fields more openly and quickly than other strategies for collaboration [7]. Thus, the fundamental changes that Twitter provides are the two-way communication between the source and the consumer of information and a wider variety of information sources. Additionally, the two-way conversation on Twitter gives a voice to stakeholders who would not normally have one in traditional healthcare interactions.
Through its ability to connect millions of people with public tweets, Twitter has the potential to revolutionize public health efforts, including disseminating health updates, sharing information about diseases, or coordinating relief efforts [9]. For example, tweets greatly helped aid workers in identifying locations to focus relief efforts in 2013 during Typhoon Haiyan. Also, Mayo Clinic posts regular updates on various medical conditions to educate its nearly 2 million followers, as seen in Figure 2.
Figure 2. The verified Twitter account of Mayo Clinic shares information about #HighBloodPressure to inform followers about the condition’s health risks.
A powerful example of the use of Twitter is that many of its benefits outlined above can potentially occur under a single post on the platform. For example, someone at a cardiology conference may respond to the tweet from Mayo Clinic about high blood pressure and discuss research on a new genetic correlation between high blood pressure and a specific gene. Another might respond by questioning the strength of the clinical outcomes of this study and other trials like it, prompting the sharing of papers. A practicing physician could respond with their experiences treating patients with hypertension. Another researcher might reply with a link to a healthcare conference where state-of-the art research on blood pressure management was presented. Moreover, a patient might ask these experts about the practicalities of dealing with a family member with hypertension. The diversity of expertise and backgrounds that can communicate on Twitter is unique, and this exchange of information can be extremely beneficial [12].
Ultimately, the sharing of information on Twitter has the potential to create a communicative and collaborative atmosphere for patients, physicians, and researchers. In this way, physicians practicing daily are connected to the newest research, researchers can identify clinical problems to solve, and patients can understand their conditions better [4,12,13]. This accessibility to information can greatly improve the quality of care delivered to patients through greater transparency and communication enabled by social media.

4. The Potential Risks of Using Twitter in Healthcare

While more accessible information on Twitter undoubtedly has the potential to benefit patient care, a major assumption made in this scenario is that all the information is accurate. Dr. Katherine Chretien and her research team at George Washington University studied the prevalence of misinformation in tweets about healthcare, and they found that about 20% contained inaccurate information [4]. The high rate of misinformation in these tweets hinders productive and helpful discussion on Twitter.
Moreover, no systematic process exists to check for misinformation on Twitter; instead, it relies on “crowdsourcing,” or voluntary contributions from medical professionals who try their best to correct inaccurate statements [4]. Thus, it is fairly easy for “non-experts, the incorrectly informed, or commercial interests” to present their opinions as fact and appear to have the same credibility as unbiased medical professionals [7]. Such scenarios can be particularly problematic for patients or students, who may have difficulty distinguishing credible from non-credible sources [7].
One example of dangerous misinformation caused by non-experts sharing opinions without scientific backing is the celebrity anti-vaccination movement. Several celebrities, most notably Jenny McCarthy and Jim Carrey, have tweeted about how vaccines have been linked to autism, despite no medical basis in fact, as seen in Figure 3.
Figure 3. Tweet from Jim Carrey’s verified account lacking credible medical evidence on vaccines.
As a celebrity comedian, Jim Carrey has a verified account, but has no formal expertise on the subject of vaccines. Twitter can be an “echo chamber of ideas,” representing shared opinion rather than balanced facts, due to the ease of quoting or retweeting messages [5]. The anti-vaccine movement has gained traction, in part because of misguided tweets and the echo effect. As a consequence, some areas of the United States are experiencing resurgences in previously-eradicated diseases such as measles [5].
Celebrities rebuking vaccinations are egregious examples of non-experts commenting on medical phenomena, but the general issue of distinguishing representatives of commercial interests from unbiased physicians is as difficult and problematic [7]. The matter is made worse with anonymous and unmarked accounts, whose claims and expertise are not easily verifiable [14]. Thus, a potential risk is the difficulty in identifying doctors on Twitter definitively and trusting certain accounts. In addition, due to the small number of characters required, tweets are often brief and must omit key information, which can sometimes create miscommunications. Particularly for complex research, it is difficult to discuss nuances, caveats, and limitations in tweets [11]. For researchers, this problem can manifest in patients misunderstanding new advances. For doctors, these risks can be extremely dangerous, as statements from a verified doctor may be taken as medical advice [15].
Another issue with sharing information on Twitter for medicine is that Twitter can transmit such a high volume of information. The amount of information makes it nearly impossible to absorb and filter all relevant tweets [7]. The same qualities that generate discussion may also bring an overwhelming amount of information. For nearly every hashtag, many professionals and non-experts may provide their insight, with illegitimate and inaccurate claims reducing the impact of the accurate expert information [7,16]. Moreover, when the accuracy of information is challenged, replies and comments may be overlooked, so the final conclusions and resolutions may go unnoticed. In these situations, more information is not necessarily better.
Moreover, lapses in professionalism are also serious potential problems with Twitter, as with other forms of social media. Previous studies have found high rates of unprofessional tweeting from accounts clearly identified as doctors [4,15]. Unprofessional behavior included profanity, complaints about patients, violations of patient privacy, and conflicts of interest. These lapses are due to Twitter’s nature and users’ inexperience.
The final potential harm of using Twitter in healthcare is the use of physician time. While making physicians and their knowledge more accessible on social media is valuable, these activities also take time out of the day for doctors. Moreover, over 80% of tweets from verified doctors are published during the workday, from 9 a.m. to 5 p.m.; this time on Twitter takes away from other potentially more important activities for daily patient care [2]. Physician resistance has been demonstrated explicitly, through commentaries about the lack of “return on investment” of involvement in social media due to lack of time and fear of distraction from their “core academic or professional activities” [16]. If a low percentage of doctors opt into social media healthcare discourse, then advice and accurate information on Twitter will be rare.
For the sharing of general information on Twitter, the risks involved with using Twitter for healthcare discourse include high rates of misinformation, difficulties verifying the credibility of sources, overwhelmingly high volumes of information available on Twitter, concerns about professionalism, and the opportunity cost of using physician time. In order to compare the risks and benefits of the use of Twitter in medicine, this paper examines the current uses of Twitter in medicine to propose a solution to maximize benefits and minimize risks.

5. Current Uses of Twitter in Healthcare

With over 2000 healthcare providers on Twitter who tweet more than once per day and have at least 300 followers, Twitter is becoming a major part of modern medicine because of the benefits it can provide. Many tweets from medical accounts share general information for public health or new research about treatments or technology. For instance, in Figure 4, Dr. Sheila Sahni, an interventional cardiologist with approximately 7000 followers and 8500 tweets, shares a recent study about the different causes and symptoms of heart attacks in women compared to men. As discussed earlier, this type of tweet maximizes the benefits of Twitter by enabling the sharing of new research and informing patients, without risking any patient privacy.
Figure 4. An example tweet from Dr. Sheila Sahni, a physician and experienced Twitter user.
However, less-experienced physicians on Twitter have tweeted comments about interactions with patients, pictures of X-rays, and cropped images of notes from real patients. While some case studies can be instructive to a general audience, extreme precaution must be taken to remove identifying patient data from the tweets to prevent privacy violations. One study reported that out of a group of 500 doctors who had over 200 followers, more than 5% of tweets were violations of patient privacy [4]. These breaches of patient privacy are unprofessional and illegal.
Moreover, Twitter accounts for doctors with fewer than 300 followers rarely had the disclaimer “Tweets are my opinions not medical advice”, which is important to inform the general public about the content of the tweets and prevent doctors from liabilities [15]. Thus, investigating tweets from health professionals revealed that doctors who are more experienced and more proficient in the use of Twitter tend to have more followers. These doctors also tend to use Twitter to maximize the benefits described earlier, such as making public health information accessible, and to minimize privacy, misinformation, and unprofessionalism.
Twitter can be an excellent tool for sharing research and connecting physicians to experts in other fields. For instance, research conferences have extensively leveraged Twitter’s capabilities to generate interest and maximize impact [12]. Physicians can also learn of clinical trials through Twitter and enroll patients which would never have had access to care otherwise [2]. Additionally, Twitter can impact patient quality of care and accessibility to health information.
Other clear applications of Twitter to medical research is the application of a multi-tiered approach of sentiment analysis, data-mining, and artificial intelligence to analyze tweets from the general population [17,18]. This real-time information can inform resource allocation for researchers and treatment plans for physicians [3]. Previous studies have shown the predictive power of Twitter for public health ranging from tracking infectious disease outbreaks, natural disasters, drug use, and more [3,4,14,15,16,17,18,19,20]. While computational power was previously a bottleneck for mining massive datasets, current advances in graphics processing units (GPUs) have enabled efficient instantaneous mining and analysis.
Examining the current uses of Twitter in medicine has demonstrated that many doctors are using Twitter effectively to share information about research among their colleagues and collaborators and information about public health for the public. However, some doctors know much less about the appropriate uses of Twitter. This knowledge gap is problematic and suggests little formal education on social media practices amongst physicians.

6. Proposed Solutions

Medical professionals must constantly communicate with patients, peers, and researchers. As social media is becoming an integral part of communication, medical professionals of the twenty-first century must acquire new skills on social media. Concerns with misinformation, privacy, and unprofessionalism necessitate clear guidelines for physicians on Twitter.
Despite this need for clear guidelines, the current guidelines from the American Medical Association (AMA) are vague, telling doctors to “use their common sense” [4,21]. The high rates of unprofessionalism and misinformation, along with the lack of consistent identifiers for healthcare professionals in the “bios” of their Twitter accounts, show a lack of formal social media education among physicians [15]. This lack of knowledge is not surprising, as traditional training for healthcare professionals does not include effectively leveraging social media for clinical or research purposes.
Thus, medical professionals must be formally trained on appropriate and effective social media use. This training is a necessity as social media becomes a bigger part of our daily lives and medicine. Similar initiatives have informed collegiate and professional athletes, who have now become major figures on social media [22]; formal instruction integrated in medical school and throughout training could even be more successful, as all medical professionals go through similar curricula.
Moreover, the AMA should enact new guidelines for the use of social media by medical professionals. These guidelines should emphasize that health professionals should maintain separate personal and professional accounts, avoid profanity, racist or sexist statements, or sexual references, respect the privacy and anonymity of patients, avoid promoting specific products or medication, and include clear statements of affiliations and conflicts of interest in Twitter account profiles [7,16]. Health professionals should try to combat misinformation as vigorously as they propagate information. Additionally, the guidelines should tell doctors to re-read their tweets before posting, as reflecting on the tweet before posting is crucial to protect patient privacy and ensure professional behavior. Moreover, using the Twitter “bio” effectively and professionally is crucial to allow patients to find credible sources of information.
While the proposed solution to educate medical professionals on social media etiquette during their training has potential to mitigate risks associated with physicians on social media, educating doctors should be an iterative and continuous process. Implementing any education program, which is better than the current complete lack of education, is a step in the right direction, but only a start. Moreover, the distinction between types of healthcare professionals, including doctors, physician assistants, nurses, and others, has not yet been addressed in the literature and requires further study for a more nuanced solution.
Ultimately, Dr. Oz, WebMD, and Twitter all share the common goal of changing the perception of medicine from a black box to something more accessible—to allow patients to understand their conditions and make informed decisions. The use of Twitter in healthcare has the potential to allow patients to be more informed about their own health, but must balance accessibility with misinformation.
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Exploring Hospitals’ Use of Facebook: Thematic Analysis #hcsmeufr #esante #digitalhealth


Background: Although health care organizations such as hospitals and clinics have widely embraced social media as a means to educate the community on health topics and increase patient loyalty and satisfaction, little is known about the content these organizations actually share when using social media channels.

Objective: This study aimed to explore the types of content US hospitals post on their Facebook pages and how hospitals’ Facebook activities differ with regard to content types.

Methods: We collected and thematically analyzed more than 1700 Facebook posts made over a 3-month period by 17 US hospitals. During the first phase, the 2 researchers coded a set of 159 posts and created an initial thematic web of content. During the second phase, the researchers coded the remaining posts and then revised, refined, and validated the initial web of content accordingly. Coding consensus was achieved on 1184 of the 1548 analyzable sampled posts (76.49%).

Results: We identified a list of 13 unique health social media post themes and classified those themes into 3 thematic groups that included announcingsharing, and recognizingactivities. The most frequently used theme was sharing health information, which appeared in 35.81% (424/1184) of the posts analyzed. Such posts sought to provide health tips and advice to community members. Recognizing special days and recognizing employees were the second and third most frequently used themes, respectively, with 14.95% (177/1184) and 11.82% (140/1184) of the posts containing those themes. The frequency of these themes was surprising as the content was geared more toward stakeholders internal to the organization, although most previous literature has focused on social media as a tool to connect with external stakeholders. In addition, we found many of the posts involved more than one theme, and selected sets of themes co-occurred frequently. For example, 25.4% (45/177) of the posts recognizing special days also included content to share health information, and approximately 38% (32/85) of the posts announcing research activities also included content to share health information. Finally, we found similarities and differences between the sampled hospitals in terms of the types of content they posted more frequently on their Facebook pages.

Conclusions: Hospitals use Facebook as an inexpensive way to educate people on health and wellness topics and to communicate different types of information and news to the public audience. Hospitals and clinics that are expanding their social media activities or are starting to embark on social media strategies can use the results of this study to better formulate their activities on Facebook.

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Why Healthcare Orgs Should Invest in Social Listening Stat #esante #hcsmeufr #digitalhealth


It’s 11 p.m. on a Sunday night and your child is complaining of an earache.

Your dreams of a restful night’s sleep? They’re headed out the window.

Do you call your doctor’s after-hours line and leave a voicemail?

You most likely turn to the 24/7 medical advice service that’s always happy to make house calls: The internet.

Technology has revolutionized how consumers access information, with answers to everyone’s burning questions a simple search query away.

Where past generations relied on counsel from trusted doctors and other health professionals, many individuals today simply hop on WebMD or shout out their symptoms in social media forums.

This transformation has certainly improved access to vital health data, but it’s also resulted in the sharing of misinformation, diminishing authority for healthcare professionals and a rash of consumers convinced that pesky mole on their forearms is something more insidious.

Yet the online landscape also presents opportunities, especially for healthcare organizations looking to proactively engage modern consumers.

Vital Signs

Approximately one-third of internet users go online to find information related to hospitals, health insurance and pharmaceuticals, and social media is increasingly the center of this activity.

Forty-one percent of people said social media would affect their choice of doctor, hospital or medical facility. And more than 40% of consumers said information uncovered on social media impacts the way they deal with their health.

Our digital reality opens the door to greater knowledge regarding health-related issues, but it often sidesteps healthcare professionals altogether. The men and women whose expertise should be shaping online discussions – the arbiters of your healthcare brand – are often absent from the conversation.


Combating this trend is about more than reasserting your organization as a trusted authority—it relates to a core concept of health care: “first, to do no harm.”

Your healthcare organization owes it to the public to understand the information people are seeking and present accurate, helpful content to counterbalance the web’s digital detritus.

Let’s face it: Health care is scary to the average person. Much of the general population views it as costly, confusing and complicated. This breeds mistrust, as well as the tendency to view health care as an intimidating, monolithic system.

It’s time for healthcare organizations to rethink their positioning, refine their reputations and humanize their brands. All this can be accomplished using the same platform driving the current transformation: social media.

Treatment Plan

Social listening allows your healthcare organization to collect and collate unbiased, unfiltered social media conversations to better understand the collective conscious of today’s healthcare consumers.

In short, social listening shows what questions people are asking and where they’re asking them, all without forcing you to traverse the risky terrain of HIPAA. Your organization isn’t divulging consumers’ personal information or accessing private files—it’s simply learning from publicly stated questions and concerns.

Approximately one-quarter of brands engage in social listening, and of those that do, 86% are able to use it to track customer requests, questions and concerns, as well as competitors (77%), industry terms and trends (61%) and industry influencers (60%).

By empowering your team to monitor social media for keywords and themes surrounding specific healthcare topics, you can identify the information the general public is asking for.

Armed with today’s widely available social listening tools, members of your marketing, customer service, communications and public relations teams will be able to zero in on the social networks and websites consumers engage with, indicating where and how to publish content to maximize reach.

Establishing your brand as a thought leader in the healthcare industry comes much easier when you’re adding to the online conversations consumers care about, as well as tracking changes in consumer health trends.

Even better, allowing health specialists on your staff to educate social users will provide a human face that inspires connection and builds long-standing relationships.

Doing so may also be a key differentiator for your healthcare brand. Only 31% of healthcare organizations have bothered to put their social media guidelines in writing, showing a serious lack of investment in consumers’ communication channel of choice. And of the healthcare brands that actively leverage social, many are solely focused on promoting their products, service lines and providers.

Healthcare organizations should be on the front line of conversations surrounding health care as a whole, and social listening indicates just where that line is. You should own your online messaging and inform healthcare consumers on the important topics they care about.


There’s no going back to our pre-digital world. A third of planet Earth’s population is expected to be active on social by 2021, and that number will only continue to grow.

What healthcare organizations must do now is take control of their digital destinies and put current trends to work on their behalf. That starts by ensuring patients have access to meaningful and accurate information that inspires trust and loyalty in your expert opinions, products and services.

So if your digital strategy could use a check-up, stop reacting to today’s trends and start pursuing a proactive solution to enhance relationships with your target audiences.

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Social Networks Are Losing A Deadly Battle With Illegal Online Pharmacies #hcsmeufr  #digitalhealth #socmed


Every social platform reviewed by BuzzFeed News had dealers pushing opioids and other prescription medicines.
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▶ Le Top 20 des Réseaux Sociaux [Classement Mis à Jour] #hcsmeufr #esante 


Quels sont les principaux réseaux sociaux en 2016 ? Quel est le nombre d'utilisateurs de chaque réseaux social ? L'infographie et le Classement
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Belong.Life and American Cancer Society to Mobilize Cancer Patients Online With Social Network #hcsmeufr #esante #digitalhealth

From, the world's fastest-growing and now largest cancer patient and caregiver social network, today announced that its new closed-member forum has generated more than one million views and more than 4,000 chat discussions with the American Cancer Society (ACS)* care team in the first six months post launch. These numbers highlight the urgent need for cancer patients to access authoritative information and connect with each other as they tackle the challenges of their diagnoses, treatment and life journey. Coupled with the fast growth of the Belong community, estimates that the ACS forum will generate more than 8 million views in the next 12 months.


The ACS Belong collaboration, named American Cancer Society 4U, opens the way for Belongers to tap the latest cancer research news, important ACS updates, access to patient-tailored online resources drawing from machine-learning technology advances, and network with members coping with similar cancer-related issues. Forum members can contact the ACS National Cancer Information Center (NCIC) directly and receive personal guidance on a wide variety of cancer-related topics.

"The connections we have created with patients via our Belong group have broadened our reach to those who can directly benefit from access to our resources and expert guidance," said Richard Wender, MD, chief cancer control officer, American Cancer Society. 

During the last six months, thousands of conversations have been held within the American Cancer Society 4U forum, touching on the most pressing patient-care priorities: treatment information and tips, coping with clinical conditions and side effects, emotional support, nutrition, ACS services, financial impact of cancer, seeking clinical trials, and others.

"Even with the closest of connections, it's difficult for supportive family and friends to fully understand what you're going through," said an anonymous Belong user battling breast cancer. "Belong provides a safe haven to share experiences and knowledge and interact with people going through the exact same thing. It is empowering to know that I'm not alone, and have access to a tremendous amount of relevant information and resources. Most importantly, my own experiences may help someone else find a smarter path, and vice-versa. We are all here for each other."

"Patients need information and support to overcome the medical, emotional, economic and physical challenges that present with a cancer diagnosis, and our ACS partnership combines the influence and mission of one of the world's great advocacy groups with the active voice of the patient," said Eliran Malki, co-founder and CEO of Belong. "We are honored to work with ACS and other global cancer-advocacy organizations dedicated to making a challenging life journey easier to navigate, by drawing on digital expertise and convenience to help beat cancer together."

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5 Doctors Who Are Killing It On Social Media Right Now


As a healthcare provider, you might think having a social media presence isn’t important to your practice’s success. However, it is a straightforward marketing strategy to implement with a high return on investment (ROI).

Social media has become prominently adopted across all generations, making it a great way to reach prospective patients. According to PEW Research Center, the demographic breakdown of people with at least one social media profile is:

  • 18-29, 88%
  • 30-49, 78%
  • 50-64, 64%
  • 65+, 37%

It’s clear that millennials are majority users of social media, but the older patient market has also become quite digitally savvy in the last few years.

With a wide variety of platforms to reach these patients, marketing your practice through social media can surely fit within any healthcare provider’s strategic business plan. But it is necessary to narrow down a direction for your brand’s online presence amongst all these options.

If you’re in need of inspiration, here are five examples of doctors who have found success using social media to their advantage.

1. Doctor Mike

Dr. Mikhail Varshavski — better known as Doctor Mike — is your average family medicine doctor but with a combined social media following of four million people. Doctor Mike has risen to ranks of celebrity-status, with features in Time, Cosmopolitan, Business Insider, and People Magazine, just to name a few.


Doctor Mike amassed his 2.8 million Instagram followers by posting photos of his daily life — on the job, at the gym, with his dog. Now you’ll see a similar stream of content, but with a slew of celebrities and sponsored events mixed in. His Instagram presence promotes a healthy and active lifestyle, alongside his busy professional work.

He keeps his followers consistently updated with a new post every few days and daily snippets shared on his Instagram story. Doctor Mike follows a strategy that relies heavily on visuals, making Instagram a perfect platform. Photos are a great way to connect with patients when it comes to online marketing for doctors. Prospective patients will get a glimpse of who you are before even stepping foot through your practice doors.

See More: Instagram 101 for Healthcare Providers

Follow Doctor Mike on Social Media:

Twitter: @RealDoctorMikeFacebook: @realdoctormikeInstagram: @doctor.mikeYouTube: Doctor Mike

2. Kevin M.D.

Kevin Pho is “social media’s leading physician voice.” On his website and blog, Kevin M.D., Pho shares stories from all aspects of the healthcare system. He provides a space for doctors, nurses, medical students, and policy experts to share their insight and experiences. As the founder and editor, Pho publishes articles on everything from physician suicide to electronic health records to, of course, social media tips for doctors.


Naturally, Kevin M.D. also has successful social media profiles of his own. His largest presence is on Twitter, with 160K followers. @KevinMD is a great example of content syndication on social media. On his Twitter account, he regularly shares articles published on his blog, inviting users to give them a read. The posts are short and sweet, with an on-topic hook and URL.

As a healthcare provider marketing your practice online, social media can maximize your content strategy. Blogging on healthcare services, trends, or topics of patient concern will allow your website to show more prominently in search results, but sharing links to these posts will offer an additional way for patients to find you online.

More on This: What to Do After Posting a Blog to Your Healthcare Practice Website

Follow Kevin M.D. on social media:

Twitter: @kevinmdFacebook: @kevinmdblogInstagram: @kevinphomdYouTube: Kevin PhoGoogle+: +KevinMD

3. Eric Topol

Dr. Eric Topol’s 2015 book The Patient Will See You Now took inspiration from what the physician refers to as medicine’s “Gutenberg moment.” In other words, just as the printing press transferred knowledge control from the ruling class to the general public, mobile technology is transferring control of healthcare from a select few to all of us.


Consequently, it doesn’t take a stretch of the imagination to understand how Topol might be the perfect example of using mobile technology to make healthcare more accessible. Topol, a researcher but cardiologist by training, tweets multiple times a day to share medical studies and direct his followers to articles that cover the intersection of healthcare data and technology.

Topol predominantly shares industry articles and retweets other accounts. His curated feed and interjected opinions serve as a news source for his followers, establishing him as a thought leader in the field. Thought leadership is also a great tactic for healthcare practice marketing. Patients will recognize the elevated level of expertise and authority, giving a greater sense of trust in your services.

Read: Twitter 101 for Healthcare Providers

Follow Eric Topol on social media:

Twitter: @EricTopolFacebook: @Eric.TopolGoogle+: +EricTopol

4. Howard Luks

Dr. Howard Luks, an orthopedic surgeon and sports medicine specialist in New York, has an active presence on all social media channels. Without the same celebrity-prestige as the three prior examples, Luks is a great example of how your typical doctor can also upkeep a stellar social media presence.


Luks regularly uploads videos to YouTube, where he discusses common orthopedic injuries and patient questions. In one video, Luks explains why meniscal tears are so common and whether surgery is always necessary for this type of injury. This video has been viewed almost 200,000 times.

“Studies report that 85% of patients are researching their diseases and their physicians online,” Luks says in his YouTube channel trailer. “Healthcare is not social, sports medicine is not social, but human beings are. Shouldn’t your physicians also be social?”

Again, digital consumers love visual content. Just think about the Dr. Pimple Popper empire. Most other healthcare provider’s online success won’t be in the same niche as her grossly intriguing video clips, but filming a short video explaining a new procedure or common diagnosis provides an efficient way for followers to engage with your practice.

Continue: YouTube 101: Video Marketing Basics For Healthcare Providers

Follow Howard Luks on social media:

Twitter: @hjluksFacebook: @Howard.Luks.MDInstagram: @hjluks1YouTube: Howard Luks MDGoogle+: +HowardLuksMD

5. Wendy Sue Swanson

Dr. Wendy Sue Swanson is a very successful doctor at the forefront of using online tools to communicate and connect with patients. As a pediatrician, she has been able to build a close relationship with her patients, in and out of the office, with her brand Seattle Mama Doc.


Following Dr. Swanson’s Facebook page is like following any other of your friends online. She frequently shares news and blogs about health issues that interest parents in particular. Her posts are conversational and personal, supporting her goal of keeping your family safe and healthy.

Swanson herself is a great advocate of social media use in healthcare and even spoke on this topic in a 2013 TEDx Talk. As a mother, she understands the importance of being able to access information online. Her social media presence also reflects her own experiences in parenting. Swanson exemplifies the perfect balance in opening up to your followers and marketing your practice brand as thoughtfully aware of a patient’s feelings.

Laurie Bleier's curator insight, June 18, 8:32 PM

Websites often provide the first impression of a practice. A website needs to establish your practice as modern, professional and trustworthy. Additionally, being responsive on all devices conveys that your practice is up-to-date and values patient convenience.

The Wild West of Medicine #hcsmeufr #esante #digitalhealth 


What could a clinician learn from Twitter, a platform famous for short messages in 280 characters or fewer? As I’ve realized over the last several months, quite a bit.

Until recently, I had assumed that social media was home to puppy photos and casserole recipes. I joined Facebook and Twitter years ago to stay connected with friends and family. But after attending a social media session here at Brigham and Women’s Hospital a few years back, I realized the role it could play in my professional life, too. I’ve found that social media is not only a way to network with others, but it’s a place where people can go to learn about the latest developments in medicine.

According to Statista, there are more than 300 million active users on Twitter any given month, and an increasing number of those are health care professionals. As a cardiology fellow, I first appreciated the role of Twitter during an annual meeting of the American Heart Association that I attended. Those at the meeting or tuning in from home could debate science or reflect on their personal experiences by following the hashtag for the meeting, #AHA17. In a matter of seconds, a national conference could have a truly worldwide impact.

Social media can do more than just connect clinicians across the country and around the world. Many are now advocating for the educational potential of the technology, hosting “Twitter chats” on subjects such as pulmonary embolism or health care disparities, while others hold recurring digital journal clubs. Even if you don’t have a wide following on social media channels yet, you can join the conversation by looking for hashtags including #MedEd or #FOAMed (free open-access medical education). Increasingly, journals are publishing digital abstracts and simplified graphics displaying the most pertinent results of a study that make for rapid sharing on social media platforms.

In cardiology, it’s common to find images on social media from coronary catheterizations or echocardiograms that may have an important teaching point. For instance, a colleague of mine in Pennsylvania tweeted a rare image of an anomalous right coronary artery coming off the left anterior descending artery, a truly once-in-a-career case. Other cardiology fellows, early career clinicians and professors alike marveled at something that we were not likely to see at their own institutions. Unique cases like these can be shared much more readily on social media than in traditional journals, and the debate regarding diagnosis or management is much more spirited, on Twitter, for example, than anything you can find in a textbook.

The strength of social media, however, is also its weakness. Just as any clinician from around the world can share an interesting case from their clinic that week, anyone with Internet access can post about anything. Credentials can be hard to find, and while Twitter and Facebook have verified profiles for politicians and celebrities, no one is patrolling the medical content posted on social media. In some ways, it’s the “Wild West” of medicine.

For example, I recently came across a follower who claimed that the influenza vaccine could cause harm. As an alternative, the person advocated a diet rich in apple cider vinegar. When I challenged the person on this, linking to peer-reviewed papers citing the benefit of vaccination in patients with heart disease, I was blocked from their profile. At that point, there’s not much you can do but move on, knowing that anyone can continue sharing their viewpoint as a social media “medical expert.”

The role of social media in medical education is still under debate. Like any new technology, early adopters are paving the way for mainstream adaptation, but there’s still a long way to go. While generally accepted as a means of sharing information, at least one organization famously came under fire after banning photos from its conference on Twitter, claiming copyright infringement. Social media won’t soon replace medical textbooks, or even UpToDate, an evidence-based clinical decision support resource, but it is increasingly becoming the equivalent of the modern-day clinicians’ lounge, a place where medicine can be dissected and debated.

For me, being one of the early pioneers in this new frontier of medicine has been incredibly rewarding. I was recently asked to host a social media session at a meeting of the American College of Cardiology, and my networking opportunities continue to grow with followers now, including journal editors, chiefs of cardiology and members of the press. Social media has also made me a better clinician, exposing me to cases and educators from around the country and the world. What about you? What have your experiences been in social media in your line of work? Follow me on Twitter at @APKithcartMDPhD and let’s continue the conversation.

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Borrow These Ideas: 5 Best Health Social Media Campaigns #hcsmeufr #esante #digitalhealth


Social media has changed the way we learn about what’s happening in the world. For consumers and businesses alike, it is a source of truth, a place to find and share authentic content, and a channel to spread the word about a product, service, or movement.

For health organizations, social media is an organic channel to address their issues, raise awareness and start a real conversation. Here are the 5 best health social media campaignswhich have done that through the power of social media.

5 Best Health Social Media Campaigns

1. #Movember: The Movember Foundation

The Movember Foundation focuses on something that isn’t often talked about: men’s health issues. They commit to saving men’s lives by tackling prostate cancer, testicular cancer, mental health, and suicide prevention.

Their annual social media campaign, #Movember, proposes an enticing challenge to ditch the razors and grow out a mustache for the month of November to raise awareness and funds. Conversations about men’s health issues are started organically: “Why are you growing out your mustache?”.

These conversations then spread through social channels that grow traction and engagement. They tell the brand story and spread awareness in an authentic way. The Movember Foundation grasps the impact that social listening has on their community.

2. Ice Bucket Challenge: ALS Association

Powerful social media campaigns have the tendency to go viral over the internet. An incredible example of this is the ALS Association ‘Ice Bucket Challenge’ social media campaign which raised over $115 million in August 2014 for ALS research. Here’s how it went down:

Three men living with ALS posted a video of themselves dumping buckets of ice water on themselves. Then they each called out one person to perform the same challenge. Before they knew it, 17 million people had uploaded their videos to social media over a span of one month. Over 400 million people watched these videos 10 billion times.

The Ice Bucket Challenge social media campaign leveraged word of mouth marketing to spread awareness about ALS and the community. It brought millions of people together, was fun and easy to do and therefore had a viral impact on the world.

3. Know your Lemons: Worldwide Breast Cancer

The Worldwide Breast Cancer organization designed an image illustrating the twelve signs of breast cancer. This image is of 12 lemons sitting in an egg carton and it spread like wildfire over social media.

The campaign that backed up this image was called #KnowYourLemons and it taught women and men to easily recognize the 12 most common breast cancer symptoms. It also inspired the world to break the taboo and fear of this disease.

Using a friendly and approachable visual to explain breast cancer is what made this social media campaign so influential and shareable. Within seconds of looking at the carton of lemons, someone was educated on the signs of breast cancer without having to deal with a lot of text or any unpleasant images.

4. World Health Day: World Health Organization

World Health Day is a day dedicated to raising awareness and an understanding of universal health coverage. This year the World Health Organization created a dedicated ‘campaign essentials’ page that armed everyone with the necessary tools to support and share the facts about World Health Day.

This page included a fact sheet, an infographic, an official hashtag, downloadable social media squares and videos. The goal was to motivate people to share at a local level in order to reach an international audience.

Having accessible, shareable content is crucial for a social media campaign to spread and gain credibility. Followers and supporters of a cause are the backbone to the success of a social media campaign and need to be armed with the right tools to spread the word in a simple and effective way.

5. #IDEFY: Planned Parenthood

Planned Parenthood launched #IDEFY, a social media campaign that inspired young people to use social media to share with the world what they defy – racism, homophobia, slut-shaming and beyond. They were asked to participate by posting an image of themselves on social media with the word DEFY written on their fist and a caption using the hashtag #IDEFY.

What was special about this social media campaign is that it was launched with a Facebook Live event at the same time that other related activations were taking place around the country.

It went live on January 22, 2017, on the 44th anniversary of Roe v. Wade and one day after the Women’s March.

Planned Parenthood aligned with activations related to their cause and timed their campaign launch very purposefully. This strategy brought a deeper, holistic meaning to their movement.

Leverage Social Media to Launch a Successful Campaign

These five campaigns prove that social media is a powerful channel to start conversations, spread the word, and raise awareness about the health issues they support.

The various strategies that these organizations leverage to make their campaign a success set the stage for other organizations looking to build their own social media campaign to raise awareness.

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Conundrum of contradictory medical studies on social media #hcsmeufr #esante #digitalhealth 


MEMBERS of the public worry and feel concerned when they read or hear about contradictions in medical studies that are promoted on social media websites. Lately, several studies on the importance of water in man’s life were posted on these websites, causing a great confusion among the public, Al-Riyadh daily reported. Some studies say drinking too much water is healthy and helps treat many diseases and reduce weight while other USA studies said not drinking too much water does not have any impact on human health, recommending members of the public to drink water when they are thirsty only.

The same studies noted that drinking water has nothing to do with weight reduction. In fact, there are countless studies with contradictory results, especially the benefits of nutrients and different diets, which confound people. Another case in point is that some doctors promote the use of certain medications while others warn the patients about the possible side effects.

Muhammad Al-Sinan, a healthcare professional, said doctors do disagree sometimes about the prescription of certain medications, as this is something natural in light of the different medical schools and references. Doctors might also differ on the mode of medical treatment, some might believe that the treatment must be surgical in order to cure the ailment, and thus make the patient undergo a surgery, whereas others might opt for therapy or other modes of treatment. Despite the fact that the end results in either case could be totally different or act as the medium of cure. It is then, when the cure happens, that people swear by the mode to give apparent weightage to a particular thought. This, however, does not necessarily mean that the doctor who prefers to operate on the patient is wrong, or the doctor who prefers to use medicine to cure is wrong. As a science, medicine has many branches and schools.

“Involving the patient in the decision of medical treatment is part of his rights. The patient has the right to partake in the decision-making process. Of course, some doctors do, unfortunately, market certain medication for personal benefit and some even try to market medications that are out of their line of specialization and this can create issues and result in mistakes,” Al-Sinan pointed out.

“Medicine is a humane profession and its primary aim is to save the life of human being. A doctor spends a long time of his life learning and acquiring knowledge in addition to practice. Unfortunately, some doctors try to increase their income by promoting less effective medications, because they have been lured into the web with hefty commissions from pharmaceutical companies to prescribe their company drug even if the patient does not need it or would have been better off with other drugs. This is viewed as indirect bribe and breach of public trust,” said Al-Sinan

Adel Abdo, former director of Middle East Center of Strategic Studies, said medicine as a science has departed from its straight and narrow path of humanitarian mission: Primarily being saving human lives. “In today’s world many doctors care only about money, especially at the private hospitals which tend to make patients undergo unnecessary medical checkups, just for money. Some pharmacies convince patients to switch to more expensive medications just for money. In some cases, the doctors and the pharma companies and the pharmacies are in cahoots to push their medicines ahead of others, despite the price and effectivity, all in the name of commissions.”

He called on the Ministry of Health to take stringent action against these people and respond swiftly with confirmed proof to put an end to a series of contradictory studies and explain to the general public the basic claims in the study, the pros and cons and the properties of the medicines and its reactions to provide a stamp of authority on what is right and what is wrong.

Bayer Company, one of the famous global pharmaceutical companies, called on the general public to take every study with a pinch of salt. It said the public should not believe any medical studies promoted on the social media websites, urging them to go and see specialized doctors and get the right medical treatment. They also asked people to go to the roots of the study to find out if it was factual and trustworthy, and not just another frivolous effort by a group of people or a competing firm, before even accepting the findings. The company also advised patients not to take any medication unless a certified doctor prescribes it and not go to the pharmacy for an over the counter purchase.

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