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Get social media training for your health care employees.


If your medical practice doesn’t engage in social media, it might be because what I’m about to show you is your worst nightmare. Health care workers tend to use health care key words when they post inappropriate material, "I'm not sure if this violates HIPAA but" is a very popular intro to a HIPAA violation. This assures that the materials shows up in streams commonly followed by other health care professionals and advocacy groups. For example this Twitter post and subsequent discussion was visible in keyword streams for "HIPAA" and "Medicare."

HIPAAviolationornot followup blurred CRP

Have you given your staff any training in social media? Not just telling them about HIPAA confidentiality standards, but explaining to them what kind of public behavior standards you expect and demonstrating exactly how to meet those expectations. Do you have a written social media policy that benchmarks those standards for any necessary employee discipline? Despite the fact that Millennials are digital natives, most of them have received zero social media training in high school or college. [1] If you want to avoid a situation like this, you will schedule a social media training session for your staff.

The possible HIPAA violation (it took me less than five minutes to find a name for this patient) might be the least of your worries. One of these young men posts highly vulgar text and photos using race and gender terms that are generally considered highly offensive by the Silent & Baby Boomer generations being served. The most vulgar of the two may not even be an employee of the same practice, but does it matter when he's part of a conversation like this? Long before this post the social media risk was already clear. Don’t be the last to know if this is the kind of thing representing your practice online.

You need to train your employees. Talk to them about how they can align their social media use with their own life and career goals. Talk to them about how their associates reflect on them. Make your social media policy public- post it on your website. Your social media policy provides context for patients when they see social media posts from your staff. Do you consider their personal social media use to not represent your practice in any way? Make that clear to your employees and your patients. You also likely need to know more about the social media use of your employees than you do now, but you must have a written policy to assure you do not violate your employees' legally protect rights.

CRP provides social media training for health care and life science companies. We also provide training to individuals, including young adults, as part of the Profile Proud Alliance.

1. Holmes, R. (2014 APR 15). 5 social media skills millennials lack. HootSuite Blog.

#SaveJosh is What Patient Engagement Looks Like When Pharma Won't Engage


Failing to engage with the viral plea to provide compassionate use experimental medication to eight-year-old Josh Hardy was a maddening, self-destructive disaster for the pharmaceutical industry. When #SaveJosh trended top 5 on Twitter, the public wasn't just engaged with clinical research, they were really, really engaged and pharma was silent. Whether or not to give the child the experimental medication is an excruciating and gut-wrenching ethics muddle in itself. The topic of engagement is about the conversation. It is about the hundreds of meetings and millions of dollars trying to get the public engaged, but then being completely silent when they were. When people are in pain and need to hear from you, silence is contempt. Ignoring the public wasn't just pharma stabbing itself in the foot, it was pharma stabbing the customers in the heart.

On Monday, the typical news report* contained little information beyond the fact that the child's doctors wanted the drug, everyone wished it might save his life, and the finger pointing to Chimerix in Cary, NC. Even if a news outlet had wanted to provide more context, where were they going to obtain it on the viral news cycle?

Major media reported that Chimerix provided a link to this ethics document [PDF] from BIO. That's great if you are writing a term paper but completely irrelevant as a reply to viral breaking news. Chimerix is a 55-person company that does not have the resources to both engage in the business of responding to the core situation, as they were doing, and also respond to the public outcry.  The term paper was the best they could get their hands on.

BIO and PhRMA are large organizations formed in part to advance the voice of their members, but they have yet to find a voice that can respond to social media engagement. They may think they respond. Both organizations have large websites with lots of stuff. But is that stuff contextually available information for social sharing? Go to each website and see if you can find what they would like to see quoted in a blog post about compassionate use.

Remember, you are a blogger who has no background information on compassionate use, you are outraged about the #SaveJosh story (Facebook link, Twitter feed link- can be viewed without a Twitter account), and you are giving BIO and PhRMA the gift of a few minutes of your time and the opportunity to be heard as you write an impassioned plea to your readers. The organizations could have alert boxes reading "Background information related to current news trends" on their front pages, but they don't. Instead, the search bar on BIO doesn't even turn up the term paper. The search bar in PhRMA turns up a long list of irrelevant material.

That blogger who really wanted to provide his readers with background information and context? He couldn't get it from these organizations.  If the blogger searches for compassionate use on Google, top returns are from the FDA, Wikipedia and some patient and disease advocacy organizations which provide information on how the compassionate use process works but do not anticipate the level of engagement where the reader starts to ask ethical questions.

The workers of pharma development were the people who engaged on the human-to-human level, providing that context anonymously and often against company policies. Self-described pharma insider "Liz in Seattle" posted a long and thoughtful explanation of the ethical issues as a comment on the CNN version of the story. Her comment was appreciated with more than 4,000 likes, stayed as the top comment the entire day of the crisis and remains there today. She even came back several times to answer questions and provide even more engagement and context. On news report comment sections, blogs, chat boards and social media channels across the country, it was people like Liz in Seattle helping the public develop their understanding of this extremely painful story.

[What do you think? Should viral stories be engaged? When the viral story is about very small biotech, who should engage?  Let me know in the comments.]

The people of Chimerix have surely been through the wringer, but you can't tell that from their website. The website URL has been posted countless times in the last week, yet aside from press releases their website is unmoved and unchanged. The link to the BIO ethics article, reportedly provided to the media, isn't there for direct communication with the public. The email address for a compassionate use program that reportedly does not exist, which so outraged social media, is still there without any additional context provided.

Throughout the crisis, Chimerix chose to use neither their website nor their Twitter feed to communicate directly with a public that was communicating directly with them. They relied on the news media to tell their story even though thousands of people received the message to go to their website.  Outdated news media-based PR in 2014 becomes a Kafkaesque game of telephone: instead of addressing the people right in front of you, you whisper what you want to say to your PR rep, who in turn whispers it to authorized news media outlets, who then are way over there blaring something that may or may not have anything to do with the input you gave them.  But this whole time time public is sitting there staring at your website and your Twitter feed demanding an answer from you: Why not direct your response to them?

Would it have mattered if Chimerix had put an alert box on the front page of their website simply acknowledging the social media outcry at the height of the crisis? The company wasn't unmoved; I have no doubt that the CEO is not heartless. For a company without the resources to bring their website up-to-date and relying on old-fashioned PR methods, the smallest possible direct communication intervention, the alert box, would help communicate transparency, openness and humanity.

Meaningful response materials from BIO and PhRMA will help improve public engagement. Of course, that means accepted that the educational material is as useful to a small biotech trying to explain its decisions as it is to a small movement like #SaveJosh trying to shepherd its supporters through an educational process. Real engagement means the tools of communication serve everyone.

Posting material on social media at the right time so that communicators at all levels can find it contextually would help. This wasn't the first compassionate use crisis and it won't be the last. No one can claim that these industry organizations are unaware this material is needed. The problem is that pharma has been so focused on what kind of engagement we can get out of the public that we've dropped the ball on what kind of engagement we can give.

[Pharma has] dropped the ball on what kind of engagement we can give.


*The typical news report has since been updated with more context without providing an audit trail to original versions. When making a call for transparency, I'm looking at you too major media.

Graphic background photo credit: Unknown Photographer, Dr. Lance Liotta Laboratory, AV-8803-3199 March 1988, US Government Public Domain

Version history: 17MAR2014 9:15AM Two grammatical errors updated.

You Don't HAVE to Use Social Media


Osos Lunch Box, Cary NCThis is Lazarus.  He has a new cafe in the South Hills Shopping Center.  The shopping center is a little tired but the DMV office, the Roses store and the other remaining stores have loyal customer bases survive and keep a steady foot traffic.  Still, the foot traffic is light enough that I meet my Mandarin tutor in the central hall for my weekly lessons. When Lazarus opened the cafe I told him that social media could help him analyze the traffic.  I showed him how you could see a lot about the different people checking in at the locations in the mall and in the immediately surrounding area.  He didn't think that information was useful to him.  This is why he might be right:

Before Lazarus opened the cafe, he operated a hot dog cart in the parking lot of the mall for three years.  Rain or shine, broiling or freezing, he was out there selling hot dogs to all comers.  By the time he opened the cafe, he already knew everyone that comes to the mall whether they bought a hot dog or not. He's that kind of guy.

You know those thick tortilla chips that are made from actual tortillas?  "Restaurant style" they call them.  Lazarus sells little bags of them along with containers of toppings.  He has a microwave and will give you a paper plate to spread out the chips and melt the real shredded cheese.  He asked me what kind of toppings I wanted and I said that I wanted the chemical-filled liquid cheese spread that comes in a jar.

The next week when I came in for my Mandarin lesson he informed me that he wasn't going to be carrying that.  He had asked all of his other customers and I was the only customer that wanted chemical-filled liquid cheese spread. He knows what everyone at the mall likes on their chips. "Besides," he said, "I care about your health."

Lazarus's business model is old-fashioned, but it is also very new-fashioned.  It isn't enough to do a demographic study any more.  If you don't know your customers by name, your competitor will stand in a parking lot for three years and get that information.  I can show you how to use social media to get a sampling of that kind of information and use relationship mapping to project how your social media using customers are influencing their friends.  I can also help you develop a social media presence where you get to know your customers better.

With all the time that saves you, stop by South Hills Shopping Center and get a plate of restaurant tortilla chips and meet Lazarus.  Tell him social media sent you.

Three Social Media Marketing Lessons from the Snowpocolypse



Wednesday, sitting in my car on Glenwood Avenue for a little over three hours, I had some time to glance at the #Raleigh #Snowpocolypse discussions on Twitter, especially when I started turning off the car to save gas.

Aside from a realtor selling beach front property offering very polite wishes for our well-being, no business were on Twitter offering any value related to the storm. (If you saw one that I missed in my fits and starts of driving, please let me know in the comments.)

I can think of quite a few businesses that should have been there.  Jeep dealer with a contest- post a picture of your Jeep in the snow. How about a sports medicine clinic- most treacherous sidewalk photo contest. Or a primary care announcing that their nurse line open for current clients. Or a masseur offering a discount for those of us that pushed a car, oof!

First social media marketing lesson of Snowpocalypse: If you don't show up to the conversation, you don't exist!


After three hours I gave up on getting home.  I was over it. The Hampton Inn at Crabtree Valley was full, but not overly so- some people who had planned to be there couldn't get in, balancing those of us who hadn't planned to stay there at all. It was Wednesday, the governor had locked down price gouging, the room was a bargain.  And yet look at the stacks and stacks (the picture captures less than half of them) of beautiful Hungry Howie's pizzas the hotel gave us!

Second social media marketing lesson of Snowpocalype: Give your customers something to talk about.


This is the real way to do social marketing: give your customers something to talk about. It doesn't matter if they tell their friends on their newfangled cell phone or if they use the newfangled social media.  How many people stuck in the storm called their partner left at home to tell them about their pizza?  I put the picture on my personal Facebook page.  If you were an independent pizza shop in Raleigh, what kind of promotional pricing would it have been worth assure your pizza a place in one of these hotels? The Hampton Inn already knew what the value was in offering it.

What happens if you don't give your customers something to talk about? 1-800-FLOWERS found out. Social media lets you put a human face in front of the customer, and they thought that meant signing their tweets with customer service representatives' names. That's not enough to balance out their ice-cold website. Their Facebook page has one lame picture of a couple of guys standing in the snow not getting anything done.

Third social media marketing lesson of Snowpocolypse: Be authentic about your human face.

Showing real people at work doesn't make anyone any happier to get half-dead flowers but it does put what they're up against into context: 1-800-FLOWERS has a ridiculous business model of shipping flowers via parcel and for the most part their people get it done even on level Impossible. We can hate the CEO and still be rooting for the employees, but even if we were inclined to do that we can't because 1-800-FLOWERS doesn't give us a glimpse of their lives. 1-800-FLOWERS thus is also proving the first rule again:

To be effective in social media marketing you have to show up!

You Can't Tweet Like the Mayo Clinic Can Tweet


Twitter feed from Mayo Clinic on #grapefruit.In 2013 the Mayo Clinic periodically posted a joke about the grapefruit diet.  On the days of the post, they owned "grapefruit" on Twitter.  If you looked for "grapefruit" what you got was the Mayo Clinic. The Mayo Clinic has more than a half million followers on Twitter: they can capture any keyword they want. (Click the post list to get a full-size view.)

Your small private practice can not do that.  If you have a few hundred or a few thousand followers, you must select keywords more strategically.  When the Mayo Clinic captured "grapefruit" on a lark, they only owned it for about a day.  They are big enough to own a different hashtag every day.  You need to be influential on your target hashtags for longer than that.

If you are in health care, go to the Healthcare Hashtag Project and look up the key words for your topic.  Once you find the hashtags for your topic, see how many tweets a day the topic gets and how many times a day the most influential people tweet. You have to use the hashtag for your core competency in posts, but if it is a highly used hashtag look for another hashtag where you can have a larger influence.

If you aren't in healthcare and no one is keeping a website of hashtag metrics for your industry, just start looking up words that make sense.  Those words will connect you to established hashtags. Also look in, a tool that helps you find related hashtags.

Another technique is to create your own hashtag.  Interestingly, #grapefruitdiet wasn't used on Twitter at that time- if it had been, Mayo couldn't have stolen it from the existing audience without a backlash.  However, Mayo could have chosen to create the hashtag at that time and continued to cultivate it as a sales channel.

Remember that if a lot of companies are already targeting the most obvious hashtag, it might not give you the best results.  Include less crowded hashtags where you can have a larger impact on the conversation.


Originally posted by Mary K.D. D’Rozario on the CRP Blog.