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Understanding Physicians OnlineGreg MatthewsOctober 25, 2012

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They’re here…

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But why are they here?

• Discover Needed Services

• Improve Customer Service

• Gather feedback on medications

• Compare and improve quality

http://www.ama-assn.org/amednews/2012/06/25/bisa0625.htm

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Contents are proprietary and confidential.

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““

With over 18,000 followers from medical communities, with

the right strategy and communication, I can leverage the real

power of my networks by using crowdsourcing very difficult

questions and issues. Twitter is the fastest and most

interactive social media channels in my work.”

Dr. Bertalan Mesko

twitter.com/berci

linkedin.com/in/bertalanmesko

Scienceroll.com

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““

Connection promotes health, and twitter proves the model that

simple digital tools can vastly increase connection.

Aaron Stupple Resident, Beth Israel Deaconness Medical Center

twitter.com/astupple

http://adjacentpossiblemed.blogspot.com/

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““

I think using Twitter and other social media outlets has

benefited me by letting me know where the patients are. I

learn from their stories and I have a chance to truly hear

them. In addition, I find social media beneficial as a learning

source to interact with other physicians and med students I

never would have met if I were confined by the walls of my

own hospital. Danielle Jones,Medical Student

twitter.com/daniellenjones

Mindonmed.com

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A benchmark

[

In 2010, Dr. Katherine Chretien of the VA Medical Center in Washington led a team in producing the first known scholarly study of physicians’ use of twitter

New, automated tools have enabled us to broaden the scope of our study

[

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on the

shoulders …Standing

The power of automation

1,397US Physicians

validated against CMS’ National Provider Identifier database

403,553tweets

generated between May 1, 2012 and September 30, 2012

Data Collected and Analyzed

between October 3 and October 15, 2012

Study

The Chretien Study

260US Physicians

5,156tweets

from 260 physicans – the most recent 20 from each

Data Collected and Analyzed between May 1st

and May 31st, 2010.

8 Contents are proprietary and confidential.

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Study Demographics

9 Contents are proprietary and confidential.

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… indexed within

of the total count

%+/- 3

Reflecting the Population

1,397US Physicians* 99.5%

Of Specialties…

10 Contents are proprietary and confidential.

Plastic Surgery

%3

Residents

%-6

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Reflecting geographic distribution

49 states

indexed within of the total count

%+/- 4

11 Contents are proprietary and confidential.

overindexes

underindexes

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Reflecting gender distribution

Underindexon twitter

by

8%

Overindex on twitter

by

8%

12 Contents are proprietary and confidential.

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Physician Profiles

contain a URL in their

bio

80%

identify themselves

clearly as such in their

twitter bio

78%

32%

link to a personal blog or website

13 Contents are proprietary and confidential.

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How are MDs using their accounts?

6.90%

1.90%

31.90%

37.70%

Bio URL Distribution

Business Medical Resource Personal Blog/Website Practice

of all Plastic Surgery URLs are links to their

practice

93%

14 Contents are proprietary and confidential.

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Twitter Activity – Time and Frequency

15 Contents are proprietary and confidential.

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Tweets Over Time

Trending steadily upward

1 5 9 13 17 21 25 29 33 37 41 45 49 53 57 61 65 69 73 77 81 85 89 93 97 1011051091131171211251291331371411451490

500

1000

1500

2000

2500

3000

3500

4000

4500

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Tweets per day over Account Lifetime

Pediatrics

Ophthalmology

Radiology

Otolaryngology

Emergency Medicine

All MD Average

17 Contents are proprietary and confidential.

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Tweets per day over 5 months

Jun’12 Jul’12 Aug’12 Sep’12

18 Contents are proprietary and confidential.

34%tweet at least 1 time per day

May’12 42%

are increasing frequency

50%

are decreasing in frequency

9% are maintaining frequency

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When can I find MDs on Twitter?

Morning Workday Work PM Evening Overnight

18% 22% 32% 12% 17%

Morning (0500 - 0800 Workday (0801 - 1200) Work PM (1201 - 1800) Evening (1801-2300) Overnight (2301-0459)

18%22%

32%

12%

17%

(0500 – 0800) (0801 - 1200) (1201 - 1800) (1801-2300) (2301-0459)

0500-0800 0801-1200 1201-1800 1801-2300 2301-0459

Eastern time

19 Contents are proprietary and confidential.

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Twitter and the MD Workflow

Morning Workday Work PM Evening Overnight

18% 21% 31% 8% 22%

(0500 – 0800) (0801 - 1200) (1201 - 1800) (1801-2300) (2301-0459)

Localized time

18%21%

31%

8%

22%

0500-0800 0801-1200 1201-1800 1801-2300 2301-0459

20 Contents are proprietary and confidential.

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The Connected Physician

21 Contents are proprietary and confidential.

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MDs Most likely to be followed by peers*

53%

40%34%

27%

25%

Personal Blog/Website

Business/ Organization

All_Doctors

No Bio URL

practice

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*Percentages measure MDs followed by at least 20 others in the data set

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How connected are online physicians?

of all MDs are followed

by at least 20 MDs 34%

Pediatrics

Emergency Medicine

Family Medicine

Specialties who are followed by

other MDs

23 Contents are proprietary and confidential.

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Topics

24 Contents are proprietary and confidential.

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Mining the Data

• Breast Cancer: (breast AND (cancer OR carcinoma)) OR (inflammatory AND breast) OR (inflammation AND breast) OR (breast AND (metastasis OR metastic)) OR (duct AND (carcinoma OR cancer)) OR (lobe AND (carcinoma OR cancer)) OR "DCIS" OR "LCIS" OR (estrogen AND receptor AND positive) OR "HER2" OR (breast AND MRI) OR (breast AND biopsy) OR (breast AND ultrasound) OR "mammogram" OR "mammography" OR "tamoxifen" OR (aromatase AND inhibitor) OR "exemestane" OR "trastuzumab" OR "Herceptin" OR "lumpectomy" OR "mastectomy" OR "komen" OR "BRCA1" OR "BRCA2”

• Diabetes: "Diabetes" OR "Mellitus" OR "Insipidus" OR "Diabetic" OR "Gestational" OR "blood glucose" OR "Blood Sugar" OR "NIDDM" OR "IDDM" OR "LADA" OR ("Antiduretic Hormone" OR "ADH") OR ("Arginine Vasopressin" OR "AVP") OR "oral glucose tolerance" OR "fasting plasma glucose" OR "glycated hemoglobin OR HbA1c OR A1c" OR "insulin" OR "SMBG" OR "hyperglycemia OR hyperglycemic" OR "biguanides" OR "Sulfonylureas" OR "Meglitinides" OR "thiazolidinediones" OR "alpha glucosidase inhibitor" OR "GLP-1 agonist" OR "DPP-IV inhibitors" OR "DKA" OR "HHS"

A sample

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All Text CloudsHashtag Clouds

Diabetes & Breast Cancer – Sample Search

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The PSA Controversy

117

182

36

Negative Neutral Positive

Doctors who state an opinion are

more than 3:1 against the USPSTF’s

ruling on PSA Tests

27 Contents are proprietary and confidential.

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Thank you

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Acknowledgements

Physician Advisor – Bryan Vartabedian (@doctor_v)

R&D Lead – Matthew Hager (@iSmashew)

Research Analyst – Kayla Rodriguez (@Kaylarodrigue11)

Designer – Nidhi Raina (@NidhiRaina)

Visualizations – Ryan Ebanks (@ebanksre)

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Appendix

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Appendix – Classification Count

Row Labels Count of classificationInternal Medicine 314Family Medicine 168Pediatrics 116Psychiatry & Neurology 100Student in an Organized Health Care Education/Training Program 83Obstetrics & Gynecology 76Surgery 74Orthopaedic Surgery 74Dermatology 55Emergency Medicine 53Plastic Surgery 46Otolaryngology 42Anesthesiology 28Radiology 27Opthalmology 26Urology 24Allergy & Immunology 16Pathology 14Neurological Surgery 10Preventive Medicine 10

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Appendix – Classification Count

Thoracic Surgery (Cardiothoracic Vascular Surgery) 9Physical Medicine & Rehabilitation 9General Practice 8Pain Medicine 4Colon & Rectal Surgery 3Hospitalist 2Nuclear Medicine 2Neuromusculoskeletal Medicine & OMM 2Medical Genetics 1Phlebology 1(blank)Grand Total 1397

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Appendix – Specialty countAllergy & Immunology 16Allergy 7Allergy & Immunology 8Clinical & Laboratory Immunology 1

Anesthesiology 28Anesthesiology 21Pain Medicine 6Pediatric Anesthesiology 1

Colon & Rectal Surgery 3Colon & Rectal Surgery 3

Dermatology 55Clinical & Laboratory Dermatological Immunology 1Dermatology 36Dermatopathology 2MOHS-Micrographic Surgery 5Procedural Dermatology 11

Emergency Medicine 53Emergency Medical Services 2Emergency Medicine 51

Family Medicine 168Addiction Medicine 3Adolescent Medicine 1Adult Medicine 5Family Medicine 151Geriatric Medicine 2Sports Medicine 6

General Practice 8General Practice 8

Hospitalist 2Hospitalist 2

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Appendix – Specialty CountInternal Medicine 314Adolescent Medicine 1Allergy & Immunology 2Bariatric Medicine 1Cardiovascular Disease 39Clinical Cardiac Electrophysiology 5Critical Care Medicine 2Endocrinology, Diabetes & Metabolism 10Gastroenterology 18Geriatric Medicine 19Hematology 2Hematology & Oncology 17Hospice and Palliative Medicine 5Hospice Care & Palliative Medicine 2Hospitalist 1Infectious Disease 9Internal Medicine 135Interventional Cardiology 7Medical Oncology 9Nephrology 14Nuclear Cardiology 1Nutrition 1Pulminary disease 1Pulmonary Disease 3Rheumatology 7Sleep Medicine 3

Medical Genetics 1Clinical Genetics (M.D.) 1

Neurological Surgery 10Neurological Surgery 10

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Appendix – Specialty CountNeuromusculoskeletal Medicine & OMM 2Neuromusculoskeletal Medicine & OMM 2

Nuclear Medicine 2Nuclear Cardiology 1Nuclear Medicine 1

Obstetrics & Gynecology 76Gynecologic Oncology 5Gynecology 6Maternal & Fetal Medicine 2Obstetrics 1Obstetrics & Gynecology 57Reproductive Endocrinology 5

Opthalmology 26Opthalmology 26

Orthopaedic Surgery 74Foot and Ankle Surgery 5Hand Surgery 6Orthopaedic Surgery 48Orthopaedic Surgery of the Spine 5Orthopaedic Trauma 2Orthopedic Surgery 1Sports Medicine 7

Otolaryngology 42Facial Plastic Surgery 9Otolaryngology 23Otolaryngology/Facial Plastic Surgery 6Pediatric Otolaryngology 2Plastic Surgery within the Head & Neck 1Sleep Medicine 1

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Appendix – Specialty countPain Medicine 4

Interventional Pain Medicine 3

Pain Medicine 1

Pathology 14

Anatomic Pathology & Clinical Pathology 13

Blood Banking & Transfusion Medicine 1

Pediatrics 116

Adolescent Medicine 4

Developmental Behavioral Pediatrics 1

Neonatal-Perinatal Medicine 1

Pediatric Allergy/Immunology 3

Pediatric Cardiology 3

Pediatric Critical Care Medicine 1

Pediatric Emergency Medicine 2

Pediatric Endocrinology 4

Pediatric Gastroenterology 2

Pediatric Hematology-Oncology 3

Pediatric Infectious Diseases 3

Pediatrics 89

Phlebology 1

Phlebology 1

Physical Medicine & Rehabilitation 9

Pain Medicine 4

Physical Medicine & Rehabilitation 5

Plastic Surgery 46

Plastic Surgery 42

Plastic Surgery Within the Head and Neck 2

Surgery of the Hand 2

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Appendix – Specialty Count

Preventive Medicine 10Occupational Medicine 2Preventive Medicine/Occupational Environmental Medicine 3Public Health & General Preventive Medicine 5

Psychiatry & Neurology 100Addiction Psychiatry 1Child & Adolescent Psychiatry 10Clinical Neurophysiology 3Forensic Psychiatry 2Geriatric Psychiatry 1Neurodevelopmental Disabilities 1Neurology 25Psychiatry 56Psychosomatic Medicine 1

Radiology 27Body Imaging 1Diagnostic Radiology 17Diagnostic Ultrasound 1Radiation Oncology 6Vascular & Interventional Radiology 2

Student in an Organized Health Care Education/Training Program 83Resident 83

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Appendix – Specialty Count

Surgery 74Pediatric Surgery 7Plastic and Reconstructive Surgery 22Surgery 32Surgery of the Hand 1Surgical Critical Care 2Surgical Oncology 4Trauma Surgery 4Vascular Surgery 2

Thoracic Surgery (Cardiothoracic Vascular Surgery) 9Cardiothoracic Vascular Surgery 8Surgery 1

Urology 24Urology 24

(blank)(blank)

Grand Total 1397