SOCIAL MEDIA AND MEDICINE

SOCIAL MEDIA AND MEDICINE

Julielynn Wong, MD, MPHMar. 4, 2014

Conflicts of Interest

I worked for the Skoll Global Threats Fund to develop the “Flu Near You” platform.

However, I have no financial ties to any products or companies featured in this talk…

Why Innovate?

“…Shake off this erroneous notion that life is there and you’re just gonna live in it, versus embrace it, change it, improve it, make your mark upon it…Once you learn it, you’ll want to change life and make it better, cause it’s kind of messed up, in a lot of ways.”

Steve Jobs, 1955-2011

Social Media

• Web applications that allow creation and exchange of user-generated content

• Billions of users

• Dynamic resource

Social Media = Exponential Technology

Categories of Social Media• Search engines

• Social networks

• Blogs

• Collaboration tools

• Social bookmarking

• Virtual environments

Google, Pubmed

Facebook, Google+, LinkedIn

Huffington Post, Twitter

Skype, Dropbox

Stumbleupon, Reddit

Second Life

Social Media• Online platforms that allow

creation and sharing (“crowdsourcing”) of user-generated content

• Facebook = largest social network with 1 billion registered users

• YouTube = video sharing platform with 800 million users

• Twitter = microblogging platform with 645 million usersB Mesko, Social Media in Clinical Practice, 2013

How Social Media Benefits Physicians

• Update clinical knowledge

• Share knowledge with other physicians

• Improve quality of patient care

Medical Applications of Social Media

• Public health

• Clinical medicine

• Patients

• Medical education

Organ Donor Rates• Organ donor rates have

remained stagnant since 2006 while need has risen dramatically

• 16 per million Canadians are registered as organ donors in 2010

• 161 Canadians died waiting for a transplant in 2012

• Enormous cost and QOL implications2012 CORR Report; 2012 CIHI e-Statistics Report on Transplant, Waiting List and Donor Statistics

Facebook Organ Donor Initiative• Users able to select “organ donor” status on their

profile and were provided links to their state donor registry in May 2012

• Study observed impact on 43 million Timeline users across 44 U.S. states over 4 weeks

• “First day effect” 13,054 new online registrations• Represents 21.1-fold increase (range 6.9x to 108.9x)

above baseline average of 4 state donor registries• Rates declined over study period but remained

elevatedAM Cameron et al. Am J Transplant, 2013

Facebook Organ Donor Initiative

• Online registrations over 13 days was 32,958 above baseline (<0.1% of U.S. Facebook users)

• Impact on U.S. donation registration rates greater than seen with prior media campaigns

• “Chronic virality” every time a user registers, a message is sent out to hundreds or thousands of other potential registrants

• Durability of “Facebook effect,” impact on transplant wait times and outcomes are unknown

AM Cameron et al. Am J Transplant, 2013

“The Inner Life of A Cell”

• Cinematic animation storytelling techniques used to engage, inform, and inspire

• Enhanced Harvard students’ comprehension of cell biology concepts

• Went viral on YouTube with +20 million viewsD Bolinsky, personal comm., 2013

Sharks Are Tweeting

• 338 sharks are tagged with transmitters• When a shark is ½ mile away from a beach, it

triggers a message to Australian surfer advisory Twitter feed

• Tweet states shark’s size, breed, and locationYu A, NPR, 2014

Social Media is a Two-Way Freeway

Patients

Physicians

Off-Label Prescribing

• 21% of all prescriptions

• Providers rely on peer-reviewed literature and individual level experience to inform treatment choice

• Can lead to clinical benefit, wasteful treatments or harmful effects

J Frost et al. J Med Internet Res 2011

• Over 220,000 patients with 2000+ conditions• Users report demographics, treatment, symptoms, and

outcomes and receive longitudinal health profiles and aggregated reports

Social Media -> Faster, Cheaper, Better Data for Treatment of ALS

• 2008 study described potential efficacy of lithium carbonate in slowing progression of amyotrophic lateral sclerosis (16 treated patients, 28 controls)

• Patients Like Me built lithium-specific data collection tool• Created algorithm to match 149 treated patients to

controls• Analyzed self-reported outcome using Revised ALS

Functional Rating Scale• After 12 months, no effect of lithium on disease

progression was seen• Consistent with subsequent randomized control trials

P Wicks et al. Nature Biotech 2011

Social Media-Based Observational Studies

Advantages• Speed of data collection• Patient access• Availability of control

subjects• Cost• Patient engagement• Pharmacovigilance• Collect early-phase data by

capturing patient self-experimentation

Drawbacks• Cannot control for

unmeasured covariates• Subjects not blinded• Lack of uniform inclusion

and exclusion criteria• Bias• Falsified data• Should be integrated with

academic/industry-led cycles of product development and evaluation

Google GlassTake pictures and video hands-free Share video in real-timeSpeak to send messages and translate your voicePerform Google searches, obtain directions

Google Flu Trends

• Google searches on flu terms

• Correlation coefficient of 0.9 for historic CDC flu trend data

• Predicted flu activity 2 weeks prior to CDC

Flu Near You

• Registered users fill out weekly email surveys on flu symptoms and vaccine status

• Higher temporal and geospatial resolution of flu activity

• Real-time flu maps and vaccine locator

Skype

• Oklahoma MD was disciplined by state medical board for Skype patient visits

• Technology outpaced regulation

• Canada established telemedicine policies for MDs

When Junk Science Became Big News• Dec. 1990: Connie Chung

airs program on dangers of silicone breast implants

• May 1995: Dow Corning files for bankruptcy in face of >20,000 lawsuits

• June 1999: IOM releases report which found no evidence linking implants with major disease

• Nov. 2006: FDA lifts ban on implants

Become An Advocate

”.. As Canadians we can and must speak out against these persistent and pernicious inequities, inequities that are shared by other vulnerable groups in our society, such as the elderly, the poor, the socially marginalized.”- Dr. Anna Reid, CMA president, 2012-2013

Blog-a-Thon Workshop

• Develop skills and knowledge on how to write online blogs

• End product will be a draft suitable for online publication

• Let’s get started!