social media in health care: fda limits liquid morphine
DESCRIPTION
A case study of how the hospice and palliative medicine field rallied to help overturn a FDA ruling that would have severely limited access to morphine, an essential medicine for pain control.TRANSCRIPT
Social Media in Health CareCase Study:
FDA Removing MorphineChristian Sinclair, MD
April 12, 2009
Background
• Morphine liquid at a concentration of 20mg/ml is an essential medication in hospice care
• It is currently ‘unapproved’ but allowed to be manufactured and distributed by the FDA
March 31st
• The FDA issues a memo notifying pharmaceutical manufacturers to stop making and dispensing a variety of opioid products that are unapproved within 90 days.
• Morphine 20mg/ml is included in the list.
• The memo is posted to the website, RSS feeds and fax. (?email?)
Late March 31st
• A nurse who I used to work with and is a Facebook friend posted a status update.
• Notice the times: I did not see this until late on April 1.
April 1st
• FDA memo mentioned by two people I follow (and trust) on Twitter– @doclake– @johnmulder
• Also hits newspapers– Never saw the story in local paper– Or online news feeds
First mention on Twitter
Re-tweeted in one hour
Re-tweeted again in few minutes
April 1st – Late PM
• Sporadic emails to AAHPM/NHPCO likely throughout the day
• Multiple discussions on local levels• FDA memo and unintended consequences
posted to Pallimed around 11pm CST• Hits RSS and Twitter immediately (800+
subscribers)• Email subscriptions go out around 2am
CST 4/2 (800+ add’l subscribers)
April 2nd
• Comments on Pallimed post begin early in the AM and continue thru day
• Commenters encouraged to contact NHPCO and AAHPM leadership
• AAHPM source says emails between orgs did not start really going until April 2nd
April 2nd late PM & 3rd
• NHPCO on 4/2– Announces on Website, ?Email
• AAHPM on 4/3– Issues email alert
• Neither post to Twitter or Facebook at that time
• Announces plan to write joint letter to FDA
April 4th-8th
• Multiple emails between major organizations detailing strategy
• Official letter from orgs to FDA on 4/6
• Individual Letters/Emails to the FDA
• Individual Letters/Emails to Congress
Thursday, April 9th
• A Facebook group protesting the memo is formed the morning before the FDA teleconference
• FDA arranges teleconference• AAHPM gets the word out by email,
Twitter and Facebook only minutes before teleconference (due to late arrangement)
• Multiple listeners on conference call– ?numbers?
Thursday, April 9th - PM
• FDA issues reversal of memo
• Morphine 20mg/ml will not be removed from the market at this time
• Although regional shortages are still present
• Announced by:– Email, Facebook, Twitter, and Websites– By multiple individuals and organizations
Reversal Announced
• On many different platforms– Individual emails– Broadcast emails– Twitter (and re-tweeted a lot)– Facebook (in many different groups)– On websites (AAHPM, NHPCO, FDA)– On blogs (HFA, About.com, Pallimed)
Lessons
• Develop your social networks across platforms for maximum effect– You must contribute to the social network or
else you will not have the connections or social capital to move messages
– Pallimed has built readership over 4 years but has never been part of an event like this
– Our readers felt empowered by a shared narrative. What is your networks shared narrative?
Lessons
• Redundancy is good– If you find something important to you, pass it
on, even if you think your friends & followers may have already heard it
– I missed the FDA memo on Facebook and the News, before I saw it on Twitter
– It is sometimes OK to repeat your message– It is better if other people do it for you
Lessons
• Be humble– I cannot pretend to think posting about the
FDA memo on Pallimed changed the world– But it could have accelerated the change– If the Twitter/Facebook and other social
networks you need are strong, you can move mountains
– Or get the FDA to reverse a ruling in 9 days.
Lessons
• Stickiness Matters– No one will forward what you had for dinner– But if you put your concern in context for your
reader/friend/follower, they will listen, and possibly interact, and possibly pass on your message
Thanks to:
• Drew Rosielle, MD– For creating Pallimed and letting me join
• My Twitter and Facebook networks– For passing on the message because it meant
something to you
• Email any questions/corrections to: