Presentation to UC Berkeley Information School Class: INFO 290A. FINDING HEALTH IN THE US: HEALTH CARE AND THE INFORMATION ECONOMY - on using social media in total health and health care http://www.ischool.berkeley.edu/courses/i290a-hcie

1. Why be Social (Media)?
Ted Eytan, MD MS MPH • twitter: tedeytan • October 4, 2013
Finding Health in the US: Health Care and Information Economy • UC Berkeley
2013
Photo: Ted Eytan, MD, Washington, DC : http://flic.kr/p/awgDVh

2. 2011
The changing face of communication: Social Media
Ted Eytan, MD MS MPH • twitter: tedeytan • October 17, 2011
Finding Health in the US: Health Care and Information Economy • UC Berkeley
© 2011 The Permanente Federation, LLC
Photo: Ted Eytan, MD, Washington, DC : http://flic.kr/p/awgDVh

5. Hi. I’m Ted.
Follow me!
@tedeytan

6. We’re here from the future
center for total health | @kptotalhealth

8. Mark Davies, MD • Jeremy Hunt
Medical Director, NHS Information Centre • UK Secretary of State for Health

9. Boris Lushniak, MD • Regina Benjamin, MD • Bob Sallis, MD
US Surgeon General • Southern California Permanente Medical Group

12. The most HEDIS #1’s
Effectiveness of Care Measures
41
Kaiser Permanente #1’s
• Comprehensive diabetes
31
21
10
2011
9
0
Medicare
care — LDL control less than
100 mg/dl (Hawaii Region)
• Osteoporosis management
in women who had a fracture
(Northern California Region)
• Breast cancer screening,
age 42–69 (Northwest
Region)
• Pharmacotherapy
Management of chronic
obstructive pulmonary
disease (COPD)
exacerbation —
bronchodilator (Northwest
Region)
• Cholesterol management
(coronary artery disease),
LDL level less than 100 mg/
dl (Colorado Region)
• Follow-up after
hospitalization for mental
illness — 30 days (Colorado
Region)
• Controlling high blood
pressure — cardiovascular
(Hawaii Region)
• Potentially harmful drugdisease interaction — total
(Hawaii Region)
• Weight assessment for
adults — body mass index
percentile (Georgia Region)
• Weight assessment for
11
Commercial
children — body mass
index percentile
• Counseling for nutrition
for children
• Counseling for physical
activity for children
• Chlamydia screening in
women (ages 16–20,
21–24 and total)
• Appropriate testing for
children with pharyngitis
• Appropriate use of
medications for people
with asthma (ages 12–
50, total)
• Comprehensive diabetes
care — LDL control less
than 100 mg/dl
• Comprehensive diabetes
care — medical attention
for nephropathy
• Antidepressant
medication management
(effective acute phase)
• Antidepressant
medication management
(effective continuation
phase)
• Annual monitoring for
patients on persistent
medications —
anticonvulsants

13. The most HEDIS #1’s
Effectiveness of Care Measures
Kaiser Permanente #1’s
• Breast cancer screening,
41
31
21
10
2012
13
0
Medicare
Source: Kaiser Permanente Newe Center, http://xnet.kp.org/
newscenter/pressreleases/nat/
2012/101012_ncqa_care_measures.html ; http://xnet.kp.org/
newscenter/pressreleases/nat/2012/112812-ncqa-medicaremeasures.html
age 42–69 (Southern
California)
• Use of Spirometry Testing in
the Assessment of COPD
(Hawaii Region)
• Pharmacotherapy
Management of COPD
Exacerbation —
Bronchodilator (Southern
California)
• Cholesterol management
(coronary artery disease),
LDL Screening (Hawaii)
• Cholesterol management
(coronary artery disease),
LDL level less than 100 mg/
dl (Colorado)
• Controlling high blood
pressure — cardiovascular
(Ohio)
• Comprehensive diabetes
care — HbA1c Testing
(Hawaii)
• Comprehensive diabetes
care — LDL level less than
100 mg/dl (Northern
California)
• Comprehensive diabetes
care — Medical Attention for
Nephropathy (Colorado)
• Comprehensive diabetes
care — blood pressure
control (<140/80) (Georgia)
• Comprehensive diabetes
care — blood pressure
control (<140/90) (Colorado)
• Osteoporosis management
in women who had a fracture
(Southern California)
• Potentially harmful drugdisease interaction —
Dementia (Hawaii)
16
Commercial
• Breast cancer screening
• Comprehensive diabetes
care — blood pressure
control (<140/80)
• Comprehensive diabetes
care — blood pressure
control (<140/90)
• Comprehensive diabetes
care — medical attention
for nephropathy
• Antidepressant
medication management
(effective acute phase)
• Antidepressant
medication management
(effective continuation
phase)
• Weight assessment for
children — body mass
index percentile
• Counseling for nutrition
for children
• Counseling for physical
activity for children
• Chlamydia screening in
women (ages 16–20,
21–24 and total)
• Appropriate treatment for
children with upper
respiratory infection
• Avoidance of antibiotic
treatment in adults with
acute bronchitis
• Use of spirometry testing
in assessment &
diagnosis of chronic
obstructive pulmonary
disease
• Annual monitoring for
patients on persistent
medications —
anticonvulsants
• Medical assistance with
smoking cessation —
advising smokers to quit
• Medical assistance with
smoking cessation —
discussing strategies

14. We stand for Total Health
© 2012 The Permanente Federation, LLC
Lenora Brogan, member
Kaiser Permanente Center for Total Health

15. 2005
Social Networking
Use Internet
100%
75%
50%
25%
AGE: < 30
0%
30-50
50-64
65+
Source: Pew Internet & American Life Project Tracking Survey, September, 2005; Pew Internet & American Life Project: Older Adults and Social
Media, August 2010, http://pewinternet.org/Reports/2010/Older-Adults-and-Social-Media.aspx
Denominator is all adults for both data points; data is for “ever have” done this activity - Charts by Ted Eytan, MD @tedeytan

16. 2009
Twitter/Status Update
Social Networking
Use Internet
100%
75%
50%
25%
0%
AGE: < 30
30-50
50-64
Source: Pew Internet & American Life Project Tracking Survey, April 2009; Pew Internet & American Life Project: Older Adults and Social Media,
August 2010, http://pewinternet.org/Reports/2010/Older-Adults-and-Social-Media.aspx
Denominator is all adults for both data points; data is for “ever have” done this activity - Charts by Ted Eytan, MD @tedeytan
65+

17. 2010
Twitter/Status Update
Social Networking
Use Internet
100%
75%
50%
25%
0%
AGE: < 30
30-50
50-64
Source: Pew Internet & American Life Project Tracking Survey, May 2010; Pew Internet & American Life Project: Older Adults and
Social Media, August 2010, http://pewinternet.org/Reports/2010/Older-Adults-and-Social-Media.aspx
Denominator is all adults for both data points; data is for “ever have” done this activity - Charts by Ted Eytan, MD @tedeytan
65+

18. 2011
Twitter
Social Networking
Use Internet
100%
75%
50%
25%
0%
AGE: < 30
30-50
50-64
Source: Madden M, Zickuhr K. 65% of online adults use social networking sites. Washington; 2011. Available at: http://pewinternet.org/
Reports/2011/Social-Networking-Sites.aspx [Accessed August 30, 2011].
Denominator is all adults for both data points; data is for “ever have” done this activity - Charts by Ted Eytan, MD @tedeytan
65+

19. 2012
Twitter
Social Networking
Use Internet
100%
75%
50%
25%
0%
AGE: < 30
30-50
50-64
Source: Zickuhr K, Madden M. Older Adults and Internet Use: For the first time , half of adults ages 65 and older are online.
Washington, DC; 2012. Available at: http://pewinternet.org/Reports/2012/Older-adults-and-internet-use.aspx.
Denominator is all adults for both data points; data is for “ever have” done this activity - Charts by Ted Eytan, MD @tedeytan
65+

20. 2012 - February
Twitter
Social Networking
Use Internet
100%
Half of internet users ages
75%
50-64 and one in three
users aged 65 and older
use social networking sites
50%
25%
0%
AGE: < 30
30-50
50-64
Source: Zickuhr K, Madden M. Older Adults and Internet Use: For the first time , half of adults ages 65 and older are online.
Washington, DC; 2012. Available at: http://pewinternet.org/Reports/2012/Older-adults-and-internet-use.aspx.
Denominator is all adults for both data points; data is for “ever have” done this activity - Charts by Ted Eytan, MD @tedeytan
65+

21. 2012 - December
Twitter
Social Networking
Use Internet
100%
75%
50%
25%
0%
AGE: < 30
30-50
50-64
Source: Duggan M, brenner. The Demographics of Social Media Users — 2012 | Pew Research Center’s Internet & American Life
Project. Washington, DC; 2013. Available at: http://pewinternet.org/Reports/2013/Social-media-users.aspx
Denominator is all adults for both data points; data is for “ever have” done this activity - Charts by Ted Eytan, MD @tedeytan
65+

22. 2013
Twitter
Social Networking
Use Internet
100%
75%
50%
25%
0%
AGE: < 30
30-50
50-64
Source:1. Brenner J, Smith A (Pew IALP. 72% of Online Adults are Social Networking Site Users | Pew Research Center’s Internet &
American Life Project.; 2013. Available at: http://pewinternet.org/Reports/2013/social-networking-sites.aspx
Denominator is all adults for both data points; data is for “ever have” done this activity - Charts by Ted Eytan, MD @tedeytan
65+

23. doctor |
th
19
century

24. §24/7 access worldwide
§9,000,000 members can
–email their doctor
–check lab test results
–order prescription refills
–manage appointments
patient |
st
21
century

25. 4.3 million members connected, via kp.org
5,000,000 members
2,500,000 members
2003
2005 2007
2009
Source: Kaiser Permanente Web Analytics, updated 10/3/2013
2013 (2Q)

26. 4.3 million members connected, via kp.org
5,000,000 members
In 2013, per month
2,500,000 members
1.2 million emails
6.2 million test results reviewed
105 thousand appointments made
35 % signed on 5 or more times
2003 2005
2007
2009
2013 (2Q)
Source: Kaiser Permanente Web Analytics, updated 10/3/13

27. and, 507,000 caregivers
550,000
Act for Child / Act for Adult
607,000 subjects
462,500
375,000
287,500
Jan, 2010
Dec 2010
200,000
Dec 2011 Jun 2012
Dec 2012 June 2013
Source: Kaiser Permanente Internet Services Group Web Analytics
Updated 10/3/13

28. The last time you had a health issue, did you get
information, care, or support from….?
Doctor/Health Professional
Non-clinician source
All patients
60%
32%
70%
70%
30%
30%
8%
2002
2011
2012
Sources: Fox S, Fallows D. Internet Health Resources: Health searches and email have become more commonplace, but there is room for improvement in
searches and overall Internet access. Washington, DC; 2003:27. Available at: http://www.pewinternet.org/Reports/2003/Internet-Health-Resources.aspx; Fox
S. The Social Life of Health Information, 2011. Washington, DC; 2011. Available at: http://www.pewinternet.com/Reports/2011/Social-Life-of-Health-Info.aspx
Fox S, Duggan M. Health Online 2013. Washington, DC; 2013. Available at: http://www.pewinternet.org/Reports/2013/Health-online.aspx

29. What caregivers want from us | each other
100%
Health Professional
Patients, Friends, Family
75%
50%
25%
0%
diagnosis, drug info, treatment
info, referral info
emotional support, quick
remedies, day to day advice
Source: Fox S, Brenner J. Family Caregivers Online. 2012. Available at: http://pewinternet.org/Reports/2012/Caregivers-online.aspx.

30. Listening, the most important innovation
e
m
o
H
Mail
News
You
Sports
Finance
Contacts
Weather
Communities
Games
Explore
Groups
Answers
Flickr
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31. Listening

32. Listening
solves
problems
social network
“linear”

33. Listening
solves
problems
social network
“connected”

34. social network
“connected”

35. social network
“linear”
time’s up!

36. social network
“linear”
more time • better solution

37. Listening, beyond the immediate network
Source: Lazer D, Friedman A. The Network Structure of Exploration and
Exploitation. Administrative Science Quarterly. 2007;52(4):667–694. Available at:
http://asq.sagepub.com/lookup/doi/10.2189/asqu.52.4.667.

38. Listening
“You know institutions tend to become static;
they build walls around themselves to protect
themselves from change, and eventually die.
You should fight that by opening up your
thinking and your ideas, and work for a
change.”
-Sidney Garfield, MD

39. Presence
Agencies, departments, and
organizations don't do things - people do
things. People's names should be on
things to foster both accountability and
pride. - Edward Tufte

40. Presence

42. I want to know about YOU - @reginaholliday

43. 2005

44. 2005

45. 2008

46. What? Always through the lens of health
Source: Twitonomy

48. Contagion