Status update

San Francisco is practically on the doorstep of Silicon Valley, so it comes as no surprise that Silicon Valley culture is playing a role in the fundraising for a new children's hospital there.

UCSF Medical Center began building a replacement children's hospital as part of its $1.52 billion UCSF Medical Center at Mission Bay project in December. Last fall, the medical center launched an online fundraising competition that aimed to use social media—websites such as Facebook and Twitter—to find new donors and, just as important, to make new advocates for the children's hospital, said Barbara French, vice chancellor for strategic communications and university relations for the University of California at San Francisco. So they organized a fundraising competition with the website Causes.

What kicked the effort into overdrive was the participation of San Francisco-based Zynga, which creates games played via Facebook. Zynga allowed gamers to purchase virtual candy canes for use in its popular Farmville game, with the very real proceeds going to the fundraising effort. Zynga easily won the contest by recruiting about 163,000 new donors, French said.

“The power of social media is the ability to engage people in causes and raise visibility and awareness for what we're doing, which is building the best children's hospital in the country,” French said. “Clearly, we've raised the hospital's visibility with people who use social media. And along the way, we raised $1 million.”

That amount is not much in terms of the overall fundraising goal for the project, which is $600 million, French said. But UCSF Medical Center now has a pool of 166,000 donors from the competition who can be tapped for future fundraising efforts and to spread the word about the hospital project, which is expected to be completed in 2014, French said.

Hospitals and physicians have been grappling with the rise in social media for several years now. Often, this is first in the form of how to regulate employee use of social media at work. A few stories of employees making inappropriate comments about patients or uploading photos that include patients to social media sites have grabbed the attention of hospital executives. At the same time, hundreds of hospitals are trying to harness social media channels such as blogs, Facebook, Twitter and YouTube to present their organizations, physicians and employees to the wider world.

Hospital communicators who work on social media emphasize that the point of using social media isn't solely about getting the organization's messages across but also about listening to what patients, physicians and business partners have to say and using that feedback loop to improve processes and policies.

Ed Bennett, director of Web strategy for the University of Maryland Medical Center, Baltimore, has been collecting data on hospitals' use of several social media websites for more than two years. In his latest tally, from January, 906 hospitals were using six social media tools for a total of 3,087 social networking sites, according to figures posted to Bennett's personal website, Found in Cache (ebennett.org/hsnl).

The six tools include the four basic building blocks of social media—blogs, Facebook, Twitter and YouTube—as well as two recent additions to his list. Foursquare is a location-based website in which users “check in” when they physically visit places and earn “badges” as they log more check-ins. LinkedIn is a business social networking site that includes company accounts in addition to individual profiles.

Hospital websites are still vitally important, but getting people to visit the site is the trick, Bennett said in an interview. “If you look at the traffic trends, Google is now the No. 2 most popular site on the Internet. Facebook is now No. 1,” Bennett said. “We're really getting to the point where, if you want to be visible on the Internet, you have to be visible on social media.”

Being visible on the Internet is a good idea for healthcare providers: The Pew Internet & American Life Project estimates that nearly 80% of adults who use the Internet search for health-related information, and even with about a quarter of adults not using the Internet, that still translates into 59% of adults looking for health information online. And for those who don't go online themselves, many have children, grandchildren or friends who do the searching for them, said Susannah Fox, associate director for digital strategy at the Pew Internet project, which is a project of the Pew Research Center.

Children's Hospital Boston built up its social media presence in much the way that most hospitals who undertake the effort do—it started without an overarching strategy or plan, and it adopted social media tools one at a time, said Matt Cyr, director of patient and family communications. What is uncommon is the wild success the hospital has had, with more than 450,000 followers of its Facebook page—the largest of any hospital in the world, according to Cyr—more than 5,000 followers on Twitter and nearly 230,000 views of its YouTube videos. The hospital also has an active blog on pediatric health called “Thrive” (childrenshospitalblog.org).

“You have to be mindful of what more broadly your organization is trying to accomplish and make the social media tools further those goals, not the other way around,” Cyr said.

YouTube was where Children's Boston started its social media presence, and it remains hugely important, Cyr said. “YouTube is the No. 2 search engine in the world after Google,” Cyr said. “To have our videos searchable on YouTube is as important as having our website searchable on Google.”

Cyr particularly likes the response that “Thrive” generates, and he wishes that more hospitals would undertake blogs. Bennett's figures show only 106 hospital blogs.

Another blog proponent is Lee Aase, director of the Mayo Clinic Center for Social Media. Mayo's goal with the social media center is to broaden the use of social media by healthcare providers by helping them develop the skills to use these tools, Aase said.

Within Mayo itself, the goal is to make every one of its 56,000 employees and students an extension of its public affairs and marketing functions, he said.

Mayo Clinic is using what Aase calls “the four basic food groups” (blogs, Facebook, Twitter and YouTube). Like Cyr, Aase sees blogs as the key. “Blogs are a crucial element because they enable you to tie it all together,” he said. “You can embed YouTube video in it, for example. You control the look and feel of your media when you post it on your blog, vs. on Facebook or YouTube. But it takes a commitment to having fresh content available.”

Paul Levy also would like to see more blogs, particularly from his former peers in hospital C-suites. Levy, who stepped down in January as president and CEO of Beth Israel Deaconess Medical Center, Boston, has been writing a blog, called “Running a Hospital,” about healthcare management and related topics, since 2006. Since announcing his resignation—on the blog as well as in an all-staff e-mail—he has renamed it “Not Running a Hospital.”

“What I had not anticipated was the power of it as a place to set forth what our hospital stands for institutionally, what I stand for personally, and to influence policymakers and other parts of public opinion on issues,” Levy said. Fellow CEOs tell him that they can't imagine taking the time to write a blog, Levy said. “I don't get that. Why wouldn't you use one of the most powerful tools available to you, if part of your job is to communicate about your organization to the outside world?”

Levy said he has never regretted the higher profile that writing the blog brought, even when Beth Israel faced tough budget choices or, last year, when Beth Israel's board fined him $50,000 for his conduct regarding a female employee. “It's going to be covered by the press. It's not like it's going to be a secret,” he said. Besides, he added, “I always felt that I had a very loyal readership on the blog and I owed it to them” to keep them informed even when the news was not good.

“This was a way of offering an unfiltered exposition of what we care about in our hospital to public officials and others,” Levy said. “In that sense, I think it was a very powerful advocacy tool.”

Like Children's Boston, six-hospital Detroit Medical Center started in social media with posting videos to YouTube, and now its efforts have evolved into a social media portal with links to Facebook, YouTube, Twitter and photo-sharing site Flickr, said Dee Prosi, vice president of marketing and business development.

“It's not just taking the cookie-cutter approach of taking a print or TV ad. You are one-on-one with people. It might be 5,000 of them, but you're one-on-one,” Prosi said. “Traditional marketing is talking at people. It's not ‘at' people anymore. It's with people.” For example, DMC ran a video contest on hand-washing, with one music video produced by the emergency staff members at each of five DMC hospitals. The contest drew 20,000 votes, Prosi said.

“Bottom line, we want to be informative, creative, entertaining and engaging,” Prosi said. “You know you're doing that by the responses you get.”

Texas Health Resources is using social media to connect better with an important constituency—physicians. Dr. Ferdinand Velasco, chief medical information officer for the Arlington, Texas-based system, said social media tools are important components in the 13-hospital system's efforts to engage physicians on adoption of electronic health records.

The EHR includes links to these internal social media platforms, Velasco said. One is called Yammer, a microblogging site that is similar to Twitter, but can be set up to be limited to a particular organization so the messages are shared internally only, he said. Similarly, how-to videos on using the EHR are shared via CareTube, a video-sharing site that also limits who can see the videos.

“It's still largely a mechanism for communicating between the clinicians and the project managers like myself. What we'd like it to be is more of a collaboration between the clinicians using the system,” Velasco said. “We're still scratching the surface.”

Aase, Bennett and Cyr all said that having a policy on use of social media by employees is an excellent first step. Hospitals that block access to social media websites often face a backlash from social media proponents, who note that employees can turn to their smart phones to access most of the sites.

The University of Iowa Hospitals and Clinics received some of that criticism a year ago. The Iowa City system blocked access to social media websites on some 6,000 workstations used in clinical areas, said Lee Carmen, associate vice president for information systems and chief information officer. The point was to keep those machines available to clinicians for accessing the system's EHR and to ensure that clinicians weren't distracted when they were in patient-care areas, Carmen said. They can still access social media sites using computers in offices and employee break rooms, Carmen said.

“I expect going forward that we will revisit this issue,” Carmen said. “I expect there will be some future functionality that will emerge that we deem important to our clinicians and to the care process that will cause us to go back and revisit this solution. We haven't found that yet, but I view that as simply a matter of time.”