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Social Media and Healthcare: What’s Next?

Interview by Jodie Elrod

Interview by Jodie Elrod

In this feature interview we speak with Dr. Kevin Campbell (@DrKevinCampbell), a nationally recognized cardiologist, on-air medical expert, consultant, and frequent contributor to EP Lab Digest, about the future of social media and healthcare.

A lot has changed in the social media realm since one of your first articles in EP Lab Digest in 2012! You noted in one particular 2012 article that “As a profession, medicine continues to lag behind other major industries in the adoption of social media.” How has the use of social media changed over just the last few years? 

I think we’re finally starting to make some headway, and I measure this by the fact that the American College of Cardiology (ACC) and the Heart Rhythm Society (HRS) have included sessions on social media in their academic programming of their annual scientific conferences. To me, that says there is definitely an interest and an awareness. I also serve on the communications committee at HRS, and there is a major push there to continue to expand social media use among members, including member to member, member to patient, and patient to patient. 

In addition, I serve on the digital steering committee for the ACC, where there is also a huge focus on creating libraries of hashtags. This is helpful when medical professionals in cardiology talk about something on Twitter — they have a dictionary of hashtags to use to reference the same terms. This can be particularly effective when at national meetings — it can help focus digital discussions.

Which social media sites do you now mainly use? 

I am very active on Twitter, YouTube, LinkedIn, and Facebook. Instagram is great, but I don’t see the same application in medicine since it is more picture oriented, as is Pinterest. On YouTube, I’ve archived every video that I’ve ever done for any major news outlet. I find Twitter to be my favorite digital platform — it is real-time, person-to-person interaction — almost like a virtual conversation. 

Would you say your main audience differs on the various social media sites?

Yes. LinkedIn is more of a professional network. Here you find a lot of job seekers and others who are interested in business leads. On Twitter, I have an audience dichotomy, including colleagues and medical professionals, as well as patients and patient advocacy groups. Because I work in mainstream media, I have a selection of media people that I interact with as well. Whichever sites you decide to use, it is vital to integrate your presence. Make sure that all of your digital platforms reference each other.

What are some of the main questions you hear from patients on social media? 

When it comes to patients, a lot of times there will be commentary or questions offered concerning treatments or breakthroughs in different technologies or disciplines. Sometimes patients express frustration when they feel as if they don’t know where to go next or they don’t feel like they are receiving the best treatment. These questions can be addressed in a global way without creating a doctor-patient relationship. It is important to “listen” to patients in cyberspace. Many patients are looking for answers, and often need our help and expertise.

What are the best ways for physicians to interact with patients on social media? Should healthcare professionals tweet with their patients? 

The best way to interact with patients is by doing it in a global way. Don’t address a particular patient’s case, and don’t give medical advice in the digital or social space. However, you can talk about general terms in relation to the disease process or complications. You can talk about new treatments or institutions that are doing novel therapies — as long as you are not entering into a doctor-patient relationship. Because if you enter into a doctor-patient relationship, you will create a legal duty to that patient. The creation of a duty or online doctor-patient relationship may create liability. It is reasonable for every physician or healthcare provider that gets involved in social media to talk with their legal counsel and understand the rules of the playground from an institutional level and simply at a malpractice law level. 

What do you find most useful about Twitter? What are some of the new tips? 

Twitter offers minute-to-minute, person-to-person interaction. The average Twitter user expects a response within 12 minutes, so this is real-time interaction that allows for sharing of ideas, opinions, debates, and discussion. It’s also a very powerful tool because users don’t all have to be in the same conference room or in the same city — heck, they can be located all over the world! In addition, Twitter now offers the user to post pictures and links, so one can still say something meaningful in a short amount of character space and also link to an ECG or an article showing primary data. 

What are your tips for creating or managing an online reputation or social media presence? Do you recommend starting with any one particular platform?

First of all, every single person has an online or digital footprint — whether you want one or not, you’ve got one. The key is to manage it, because if you just let it be, then you’re going to be judged by whatever those reviews on some doctor review site say about you. It’s very biased and difficult to manage. You want to manage your own digital reputation and footprint. You do that by getting out front, which can be done in several ways. First, you can teach colleagues, patients, and/or industry about what you do and what you think are the latest and greatest breakthroughs, consulting and working together to solve problems. You can help support patient groups or be a patient advocate in the social space. You can advocate for change via concerns such as healthcare (i.e., Affordable Care Act) and make things better. You can also get involved in research and new ideas, or involve yourself in hypothesis generation and think tank discussions, particularly on Twitter. Those are some of the key ways to get involved. As a first step, I would say just get out there ­­— get out into the social and digital realm, sign up for a Twitter and Facebook account, and become a listener. See what’s going on out there, and then wade into those waters as slowly or as quickly as you’d like. 

It’s been said that physicians may be reluctant to engage in social media because of the added time investment and risk of burnout. What do you recommend?

You’ve only got a certain number of hours during the day, so everything you do has to be with purpose and with a return on investment. I’m not talking about a dollar return on investment, but an equity return on investment. I find social and digital media to be an enormous return on investment. For example, in my own career, social media such as Twitter has helped me to land network appearances on mainstream media and has continued to develop that mainstream media persona. It also helped me to get my first 2 book deals and become a writer for U.S. News & World Report, Forbes Magazine, even EP Lab Digest, because of my digital presence. I think that you get what you put into it, and again, everybody has to decide what their calling is and what they want to do, but I think digital is where our patients are and where we need to be. If we want to effectively connect with our patients, we must go to the digital space and be present. Otherwise there is a void, and when there is a void, there is often misinformation. If we’re present, we can allay fears, sweep aside any misinformation, and make clarifications. 

What changes do you think we’ll see coming up in social media? 

I think we’re going to see new applications. I had the honor of being part of an FDA think tank on pharmacovigilance this summer. In the think tank, we brought together experts from all over the U.S. and the world in order to discuss issues with drug and device post market safety monitoring. Currently we are using a flawed monitoring system — you have underreporting, duplicates in reporting, reporting bias, and overreporting of adverse events. The think tank meeting at the FDA campus in Washington, DC looked at social listening as a potential tool to identify adverse drug and device events. This means sampling all of the digital space using artificial intelligence, search terms, and algorithms that are very smartly written by engineers and computer scientists, to look at what patients are putting out there in the digital space, and then flagging those comments that seem like they may be clustered together to give us an idea that there may in fact be some sort of adverse event. It might be a way to find an unknown event or effect in a particular drug or device. Once we figure that out, it may be a better way to monitor for these events. As a think tank group, we’re at the point now of coming up with ideas. Next steps will include pilot studies through the FDA and some organizations that are affiliated with it to determine if it’s feasible to separate all the social/digital “noise” out there from the really important information. It’s an exciting project to be involved in.

Kevin R. Campbell, MD, FACC is with North Carolina Heart and Vascular and UNC Healthcare. He is also Assistant Professor at UNC Department of Medicine, Division of Cardiology, and Director of Electrophysiology at Johnston Health. In addition, Dr. Campbell is President of K-Roc Consulting, LLC.

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