Thursday, June 30, 2011

Who will Drive Social Media Use in Health Care? Part 1

In his blog post titled Social Media in Health Care:  Barriers and Future Trends, author John Sharp notes that social media has invaded health care from at least three fronts:  startups, patient communities and medical centers. These three groups will continue to drive and expand the use of social media in health care over the next five years.  However, I believe other three other groups will also exert influence and expand use: physicians, pharmaceutical and medical device manufacturers, and the federal government. Over the next three weeks, I'll examine the impact of each of these groups on the future of health care social media.

This week I consider the evolving influence of physicians.  Physicians have not been active in social media for several reasons:  lack of clarity on appropriate use of social media, slow adoption of information technology, and payment schedules that don't reimburse for patient conversations.   These factors are becoming less of a deterrent to the use of social media by physicians.

Crystallizing professional guidance

Major organizations such as the American Medical Association are issuing guidelines to help clarify the appropriate use of social media by physicians. Influential physicians who are active in social media, such as blogger Dr. Kevin Pho of KevinMD and Val Jones of Better Health, also provide useful guidance and lead by example. The newly established Mayo Center for Social Media also explores the appropriate use of social media by health care professionals in its blog series titled Friday Faux Pas and in its video project, The Doctor is Online: Physician Use, Responsibility, and Opportunity in the Time of Social Media.

Impact of telehealth

The American Telehealth Association (ATA) defines telehealth as "remote healthcare that does not always involve clinical services. Videoconferencing, transmission of still images, e-health including patient portals, remote monitoring of vital signs, continuing medical education and nursing call centers are all considered part of telemedicine and telehealth."   According to a survey of 2000 US physicians, 7% use online video conferencing to communicate with patients.

Use of telehealth technology is expected to grow because it provides a way to improve physician productivity and enhance the quality of care. A recent study by Kaiser Permanente found that among 35,423 patients with chronic health conditions, those that used email to communicate with their doctors saw a statistically significant improvement in health effectiveness measures.   Dr. Ron Dixon, Director of the Virtual Practice Project at Massachusetts General Hospital, also noted that information technology offers the ability to improve coordination of care among various providers.

Expanded reimbursement

A nationwide phone survey of 72 programs offering telehealth services by AMD Global Telemedicine, supplier of telemedicine technology found that more than half are currently receiving reimbursement from private payers. Private payers currently reimburse for telehealth programs in at least 25 states.   According to the survey over 100 private payers currently reimburse for telemedicine services. 

A survey conducted by the Center for Telehealth & eHealth Law found that 39 states have some reimbursement for telehealth services, though the extent of coverage depends on many factors.  Similarly, the Centers for Medicare and Medicaid Services (CMS) also provides limited coverage for telehealth services. Recently, however,  the ATA sent a letter to CMS Administrator Dr. Donald M. Berwick, asking the U.S. Department of Health and Human Services, of which CMS is a part, to  waive restrictions for telehealth services under Medicare Parts A and B.

Social media safe havens

Additionally, the increasing popularity of secure “communities” where physicians can exchange clinical information will hasten adoption of information technology.  Since its launch in 2006, 20% of all US physicians have become members of Sermo, an online community where practicing physicians discuss clinical issues and practice management.  Doximity is another private network for physicians and other medical professionals.

The rise of e-patients

The emergence of e-patients, patients who are engaged, empowered and active online, will also encourage physicians to use social media.   The Pew Internet and American Life Project found:
  • 80% of internet users (or 59% of adults) have looked online for health information
  • 34% of internet users  (or 25% of adults) have read someone else’s comments about health or medical issues in an online news group, website, or blog.
If physicians are to remain a relevant source of medical information for patients, they will need to establish their presence online as well as offline.  

Next week I'll look consider the factors influencing increased social media use by pharmaceutical and medical device manufacturers.


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