A week or so ago, I had the pleasure of leading a webinar on the use of social media for hospitals. I was invited to deliver the webinar by the folks at Caretech. (The participant evaluations of the sessions were terrific; thanks to all who attended!) When the hour was up, there were still a lot of questions in the chat room and I got a few more by email. As I’ve done in the past, I’m answering the remaining questions here.

Handling critics

There were two questions about addressing criticism. Here’s the first:

We wondered if you had any examples of how hospitals are successfully engaging their critics online. You mentioned the billing example, but we were wondering specifically about critics who might have complaints about their care or their clinical outcomes.

How do other hospitals handle online interactions with, say, a disgruntled former patient? We want to fully engage, even with those who disagree with us, but we’re also mindful of the legal implications of interacting with someone with whom we may have a legal situation at some point.

What’s the best way to handle an online comment from someone who may sue you? If the comment were in the traditional media, we would decline to comment on a specific patient’s care or on any pending litigation.

In a thread online, though, it seems like we have the choice of a) ignoring the comment, b) posting an explanation of why we can’t/won’t comment along with whatever we can say about the situation or c) deleting the comment itself (if it were on our blog or Facebook page).

How are others handling this? What would be your recommendation on the best way to approach this?

And the second:

What is your suggestion for hospital marketing personnel for situations that come up when there is a negative response to a hospital service, event, etc. that seems to develop into a groundswell of criticism?  I think this is the fear of those of us who are responsible for social media.  If you sound too defensive, it will be a turn-off, but if you don’t respond at all, it’s looked at as a cop-out.  Any thoughts on this?

Some of the people who are unhappy with your organization are going to talk about it online, whether you like it or not. Nobody needs your participation in order to post a bad review to Yelp, Twitter, their Facebook updates or blogs. As Cindi Bigelow, CEO of Bigelow Teas put it:

My feelings are that [even] if you don???t provide a blog, or something like it for your company, people are going to talk about you and your products, so why not provide them an environment where people can talk in front of you and not behind you? I???d rather you yelled at me directly than behind my back; this way I can at least explain where I???m coming from.

Bigelow was talking about addressing her decision to continue sponsoring Don Imus’ radio show after the radio personality’s reputation tanked after objectionable remarks made about the Rutgers women’s basketball team.

Negative comments are likely, since no organization can please every customer all the time. Allowing such comments to appear lends credibility to your organization’s willingness to be open. General Motors Vice Chairman Bob Lutz, one of the pioneer corporate bloggers, noted more than once that moderating out all the negative comments will only make it obvious that you’re not willing to address criticism. More important, it gives you an opportunity to address the questions and concerns.

When you encounter a comment that is critical of the care they (or a loved one) received, you can best address it by asking for personal contact so you can move the conversation offline (and, presumably, toward the same resolution that would have occurred had the individual picked up the phone rather than post a comment). This isn’t to deflect the conversation from the public’s eyes, but rather to maintain patient privacy. Publicly, you’ll be seen as responding to the complaint. As for the individual who simply can’t be made happy, your good-faith efforts to try to resolve the issue are visible. You may even find other readers jumping to your defense, a common occurrence in the self-policing environment of the Net.

There could, of course, be instances in which the complaining patient is right, in which case good communication practices that predate the social media era apply: Apologize for whatever mistake the hospital made, outline what’s being done to prevent a repeat occurrence, and do what’s right by the patient.

These principles should also apply to patients and others who post their complaints on properties like Yelp over which you have no control.

As for legal concerns, the evidence suggests that addressing complaints will most likely minimize legal action. Fewer people are likely to sue organizations they see as doing the right thing while those who do opt for legal action are likely to get lower judgments from juries that don’t view the organization as the bad buy because it took steps to rectify the situation. (Listen to this discussion with an attorney and a crisis expert who address this issue broadly as well as from a medical malpractice perspective.)

Not every comment should be published, however. You need a comment policy that clearly articulates the kinds of comments that are not acceptable. These usually include comments containing personal attacks, foul language, privacy violations and copyright infringement. (Here’s an example from Texas system Scott & White.) One organization, the TSA, actually features a counter on its hope page displaying the number of comments that have been deleted.

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The wrong audience

I’ve read some marketers posts who advise against jumping into social media saying it’s overrated and that when you look at the “followers” and “friends” hospitals have on social media platforms, you’ll find that they often aren’t concentrated in the hospital’s state, let alone city. So they’re not in the hospital’s market. (My organization has) just put together a work group to establish our goals, strategies, objectives and tactics for getting involved in social media and so I am interested in your thoughts in terms of using social media as one of our marketing tools.

I wouldn’t presume that a social media effort—or any other marketing/communication effort, for that matter—is “overrated” without assessing how well the effort as met its objectives. A lot of social media efforts fall short because they were not implemented strategically—that is, they were not aligned with business goals.

If you approach social media strategically, as a part of a larger communication effort, you’re far more likely to experience solid, measurable results.

Worrying about followers isn’t worthwhile. For example, a recent study determined that there is no correlation between the number of Twitter followers you have and how influential you are. Keep in mind that someone who is considering visiting your hospital may well check out your Facebook page and see the posts to your wall and the conversations (not to mention the content you’ve uploaded, such as photos and videos) even if they haven’t “liked” your page.

But that’s not to say you can’t employ tactics to bring local residents to your page. I’m seeing more and more billboards that include Facebook and Twitter icons to let people know these channels are available. You can include the same invitation in your other traditional marketing to the local community, from direct mail to handouts at community events.

By the way, some of the hospitals I’ve worked with are trying to attract patients from out of town!

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Twitter for hospitals

I am curious as to examples of using Twitter in a way that would be beneficial to our hospital. We currently have a Facebook page and are looking for other ways to get a message out.

As with any other communication, you should try to align your Twitter activities with the objectives you’re trying to achieve. Most of the hospital accounts I see are multi-purpose. They’re used for the following purposes:

• Links to announcements such as blog posts and press releases
• Announcements and reminders of events
• Responses to inquiries and complaints (I like one of these I just saw on the University of Arkansas hospital account, which reads, “Is there anything we can help you with? Here is a link to our pocket guide: http://cot.ag/buABkN”.)
• Appreciation of volunteer activities
• Recognition of staff achievements
• Live-tweeting of events and activities
• Retweeting interesting or relevant tweets
• Pointing followers to media coverage of the hospital
• Linking to articles and posts of interest to followers
• Thanking people who have nice things to say about the hospital

Keep in mind that some people opt to use Facebook and others Twitter—not everyone is using both services (evident from the disparity between the 400 million-plus on Facebook and the 70 million with Twitter accounts). You may determine your best strategy is to duplicate your status updates and tweets in order to make sure your message reaches people interested in following you, regardless of which service they use.

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Sources of statistics

Can you share with us the best sources for compiling social media usage statistics overall and by platform?

Sure. First, I have a list of sources of demographic information on my site.

Facebook maintains a page for its own statistics here.

SEOOptimise has a nice list of social media statistics, as do Altimeter Group partner Jeremiah Owyang and Mashable.

eConsultancy usually updates its fascinating collection of statistics every few months.

Social Networking Watch regularly updates its site with the latest data it collects from a variety of sources.

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Time commitment

How much staff time is required to manage just social media channels? How can we estimate the amount of staff time required to support the effective use of a blog, Facebook page(s), YouTube channel, Twitter? As a small hospital, we have limited staff and don’t want to begin something that we can’t support.

This question comes up a lot and is difficult to answer, since the amount of time you’ll invest depends on the tactics you opt to employ. This goes beyond just having a Facebook page or a Twitter account; the resources you’ll need will depend on how you plan use them.

The amount of time required will be greater when you’re getting started than when you these activities become a routine part of your communication effort; it’s a learning curve. However, it’s also worth noting that, the more you use these tools, the more you’ll find yourself scaling back on others. Many of those I know who adopt social media find, for example, that they’re dealing with considerably less email. You’ll also find that these tools become better channels for dealing with issues that arise than older communication channels. I’ve spoken with people who find a blog, for instance, allows them address inaccurate media coverage in minutes instead of the hours and hours it takes to get a correction published. You need to factor into your concerns about time the amount of time social media will save you.

There are also ways to consolidate your efforts. I’m working with one hospital that is recruiting staff volunteers to write blog posts for a group blog (not unlike Southwest Airlines’ blog). They’ll email their posts to a Posterous email address where the communicator will review them, then approve them to appear on the blog. Posterous will automatically add the posts to Facebook, link to them on Twitter, and add photos to the hospital’s Flickr account and videos to the YouTube account.

Since it’s so difficult to provide an answer to the general question, though, I’m planning to ask several of the hospital communicators I know how much time they’re committing to social channels. I’ll publish the results as a blog post here sometime in the next couple weeks.

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Events

Regarding Facebook, with events showing up in fans news feeds. Is this a new feature with the introduction of LIKE? I don’t remember that Page events automatically went into news feeds…but maybe so.

I probably rushed through the explanation of “Events” faster than I should have. Sorry!

The event shows up news feeds through a somewhat circuitous route. If I RSVP to an event that you list, my friends will see the event show up in their news feeds. You can get more information on how this works from the Facebook advertising guide (PDF).

Of course, you can create a status update about the event with a link to the actual event listing. These notices will go into the “updates” section of the inboxes of those who have “liked” your page. While some argue that nobody checks the “updates” part of the inbox, I’ve seen a lot of success with those pages that make sure their fans know about the update feature.

Event notices create on groups (rather than pages) are distributed to group members.

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Relevance to 55+

How does this fit in with our primary target group that is 55+ years old?

In the U.S., according to Forrester’s Technographics tool, only 30% of those 55 and over are inactive in social media channels. 64% are spectators, reading, watching and listening to social content. 26% are joiners (using Facebook and other social networks); there are more grandmothers on Facebook than high school students! You can break this down further by gender on the Forrester Technographics page.

As a Dallas News story notes:

The largest percentage increase in Internet use since 2005 has been in the 70-to-75 age group, according to the Pew Internet and American Life Project. The survey found that 45 percent of that age bracket is online, compared with 26 percent in 2005.

I’d also point you to a recent Mashable item on an eMarketer report that shows a surge in adoption of social media by seniors and boomers. Here’s a summary:

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Downside

Have there been negative consequences with Mayo U of M or Henry Ford from using Social Media?

Not that I’m aware of. That doesn’t mean there haven’t been issues. Frankly, it’s likely that you’ll have some negative experiences in an environment you cannot control. The question is one of risk vs. value. Are you achieving more positive results than negative ones? You can take steps to mitigate risks while constantly refining your strategy to produce greater value.

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Privacy

What about security and HIPAA privacy concerns?

This has nothing to do with social media or any online platform. Privacy and HIPAA can be violated anywhere, as Beth Israel Deaconess Medical Center CEO Paul Levy notes:

Any form of communication (even conversations in the elevator!) can violate important privacy rules, but limiting people’s access to social media in the workplace will mainly inhibit the growth of community and discourage useful information sharing. It also creates a generational gap, in that Facebook, in particular, is often the medium of choice for people of a certain age. I often get many useful suggestions from staff in their 20’s and 30’s who tend not to use email. Finally, consider the cost of building and using tools that attempt to “track utilization and monitor content.” Not worth the effort, I say.

You can reduce the chances of staff inadvertently violating privacy by ensuring your policies and guidelines are well communicated and continually reinforced. You should be conducting annual HIPAA training anyway, so be sure to include discussion of staff online activities in the discussion.

As with the question above on negative consequences, you have to evaluate the worth of your social activities against the risk. If you search, you won’t find too many instances of privacy violations of this type, while you’ll find a ton of material about the benefits hospitals are accruing.

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Blocking

What is the state of ‘blocking’ in hospitals (ie, IT dept doesn’t allow access to social network sites). Is it better or worse than in the typical non-healthcare organization?

I haven’t seen any statistics for hospitals blocking employee access, although I haven’t run into many hospitals that do. You’re more likely to find streaming services like YouTube and Pandora blocked because of bandwidth issues (as opposed to an effort to keep employees off of social networks).

In the U.S., 54% of organizations block access, a short-sighted and potentially damaging move. If you’re interested in information and resources on this issue, I’d suggest you visit a site I’ve set up that’s dedicated to ending the practice of blocking, Stop Blocking.

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Monitoring

What advise can you offer up on monitoring, and responding to, negative comments on Facebook from people who are either not fans of the organization or are not in your social network - meaning there is no way to open a dialogue with them to shift their negative perspective of the organization to a positive one?

I’ve addressed the question of responding earlier in this post. As for monitoring, every organization needs to monitor for references to itself. The simplest way to do this is by setting up Google Alerts (which you can set for news items, blog posts, video, or all references). There are some other free services that keep you updated on mentions in the social space and provide some useful statistics, like Social Mention. Ideally, you’ll contract with a reasonably-priced service like Radian 6 or CustomScoop.

Here a nice list of social media monitoring services.

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Getting started

For those just starting out with social media, what types would you recommend? Facebook? Twitter? A wiki?

It depends on what you’re trying to achieve and whom you’re trying to reach. In general, I do believe hospitals should consider a Facebook page, a Twitter account and a YouTube channel. The Facebook page accommodates the growing population of Facebook users who prefer to get their information there. After all, Facebook is rivaling Google as a source of searches! Twitter is, at its core, a news delivery service that many people have adopted as a surrogate for RSS news readers, so it’s a quick way to reach people with updates. And YouTube ensures your videos get distribution beyond your own website. But I’d still counsel that you undertake a strategic planning exercise to determine which social channels will best help you achieve your goals.