It turns out some­one has been send­ing out employ­ment offers around the world promis­ing a job at the Hol­i­day Inn Kens­ing­ton Forum in the UK. The let­ters are signed “Alex de Carvalho”.

For the record, I am not the Alex de Car­valho in ques­tion. I do not work for the Hol­i­day Inn, I do not live in the UK, and I am not related to the per­son who is send­ing out these letters.

This 419 scam has been doc­u­mented at the fol­low­ing links:

http://www.fraudwatchers.org/forums/showthread.php?t=36023

http://www.419scam.org/emails/2010–02/14/01009521.29.htm

For more infor­ma­tion on what a 419 scams and advance-fee frauds, see the fol­low­ing: http://www.419eater.com/ and http://en.wikipedia.org/wiki/Advance-fee_fraud

And that’s just the way the cookie crum­bles.

UPDATE: There’s a good thread on Yahoo! Answers about this: http://uk.answers.yahoo.com/question/index?qid=20100601231817AAml806

You may also con­tact the hotel directly:

LONDON KENSINGTON FORUM
97 CROMWELL ROAD
LONDON SW7 4DN
ENGLAND
Hotel Front Desk: +44–871-9429100
Hotel Fax: +44–20-73731448

419, fraud, scam, advance fee, hol­i­day inn, kens­ing­ton

tl;dr: So you’ve been tasked with “tack­ling” social media for your orga­ni­za­tion: now what? At the Eye­For­Pharma eMar­ket­ing Sum­mit 2010 in Berlin, I pre­sented “5 Keys to Imple­ment­ing Social Media,” a frame­work to help you define your organization’s social media activ­ity. This post sum­ma­rizes the first key, mon­i­tor­ing your brand online. As a dis­claimer, I am the co-founder of a brand mon­i­tor­ing ser­vice for the life sci­ences indus­try.

If mar­kets are conversations …

“Any savvy party goer knows to lis­ten before jump­ing into a con­ver­sa­tion at a cock­tail party.” -Jere­miah Owyang, Part­ner, Altime­ter Group

“There’s no tagline” to con­ver­sa­tions, accord­ing to the Clue­train Man­i­festo: “For thou­sands of years, we knew exactly what mar­kets were: con­ver­sa­tions between peo­ple who sought out oth­ers who shared the same inter­ests. Buy­ers had as much to say as sell­ers. They spoke directly to each other with­out the fil­ter of media, the arti­fice of posi­tion­ing state­ments, the arro­gance of adver­tis­ing, or the shad­ing of pub­lic relations.”

All sell­ers and brands may not be fully aware yet (see the social media adop­tion matrix) but their con­sumers sure are talk­ing about them. Whether you believe these inter­ac­tions should be called “con­ver­sa­tions” or “self-publishing,” research by Penn State Uni­ver­sity found that “20 per­cent of all tweets—or one out of every five updates—mention spe­cific brand names or prod­ucts.” As for the value of these tweets? “There’s room to glean qual­i­ta­tive analy­sis about brand per­cep­tion and affin­ity from them, at least.” -Jim Jansen, Penn State (and some “Com­pa­nies court tweet­ers and blog­gers”).

A large pro­por­tion of these con­ver­sa­tions are related to health. Accord­ing to Pew Inter­net, 61% of Amer­i­can adults look online for health infor­ma­tion (June 2009).

Fully 42% of all adults, or 60% of e-patients, say they or some­one they know has been helped by fol­low­ing med­ical advice or health infor­ma­tion found on the internet.

In Ger­many alone, “there are more than 100 health-related search queries per sec­ond,” accord­ing to Jens Mon­sees from Google, cit­ing 2010 search stats at Eye­For­Pharma in Berlin.

… are you listening?

Accord­ing to Jere­miah Owyang, “In the social media com­mu­ni­ca­tions life­cy­cle [pic­tured above], com­pa­nies often fail to lis­ten .… One of the biggest prob­lems for [online] com­mu­ni­ca­tors today, just like a real con­ver­sa­tion, is learn­ing to listen.”

For exam­ple, do you know:

• Whether your clients and con­sumers are men­tion­ing your brands, prod­ucts, and ser­vice experiences?
• What are physi­cians dis­cussing online, and who’s becom­ing influential?
• How do patients feel about your brand?
• Is the med­ical con­tent accurate?
• Is your pro­mo­tional activ­ity effective?
• In what con­text are your brands mentioned?

By becom­ing aware of your online men­tions through­out social media sites and plat­forms (see the con­ver­sa­tion prism), you will effec­tively and quickly gain new insights, to:

• Under­stand your cus­tomers and your community
• See how and where your brands are mentioned
• Pin­point cus­tomer sat­is­fac­tion issues
• Find out what really con­cerns physi­cians and patients
• What and where is the false information?
• How are com­pet­ing brands perceived?

Social media mon­i­tor­ing tools help keep your team orga­nized and on top of mar­ket trends. For exam­ple, like a canary in the coal mine, online men­tions of Avan­dia were clearly mul­ti­ply­ing pre­ced­ing the announce­ment of the drug’s recall. On a more pos­i­tive note, the buzz on Her­ceptin increased five folds fol­low­ing pub­li­ca­tion in Europe’s Lancet about pos­i­tive results clin­i­cal tri­als for Her­ceptin, a part of the chemother­apy reg­i­men for HER2 pro­tein pos­i­tive breast can­cer (The Lancet, 2002). How­ever, some physi­cians and patients had allegedly been using Her­ceptin treat­ment before chemother­apy, to reduce the size of lumps in HER-2 pos­i­tive patients, and shar­ing their expe­ri­ences online. After recent clin­i­cal tri­als were per­formed, these proved the drug did indeed improve progression-free sur­vival before start­ing the chemother­apy reg­i­men (The Lancet, Jan­u­ary 2010).

That’s all very well, but how does one keep track of online mentions?

Brand mon­i­tor­ing platforms

There’s a grow­ing cat­e­gory of Soft­ware as a Ser­vice called brand mon­i­tor­ing, with a num­ber of sys­tems that work to col­lect and ana­lyze the online buzz about your brand and the key words that mat­ter to you. Rather than con­duct­ing daily man­ual searches through blog search engines, these sys­tems are con­ve­nient when you need to per­form the fol­low­ing activities:

1. Pull men­tions from blogs, videos, med­ical resources and forums, patient and physi­cian social networks;
2. Track specific top­ics, drugs, dis­ease, ther­a­peu­tic areas;
3. Graph­i­cally dis­play daily men­tions, rolling averages;
4. Con­duct sen­ti­ment analy­sis and other types of data mining;
5. Cre­ate auto­matic alerts for unusual or increased online men­tions activity;
6. Fil­ter out low-value or irrel­e­vant mentions;
7. Del­e­gate men­tions for fur­ther action by your team;
8. Ticket men­tions to keep track of issue res­o­lu­tion and prob­lem solving;
9. Anno­tate and archive men­tions for record keep­ing and future retrieval;
10. Export weekly, monthly, or quar­terly inter­nal reports;
11. Post responses on social sites like Twitter;
12. and more.

Your social media busi­ness case and resource allocation

When con­sid­er­ing social media for your orga­ni­za­tion, there are few steps as impor­tant as under­stand­ing where you fit in the con­ver­sa­tion online. Social media mon­i­tor­ing allows you to more effec­tively man­age your rep­u­ta­tion, track your com­peti­tors, and mon­i­tor mar­ket trends. As a side ben­e­fit, what you find out in terms of the qual­ity, vol­ume, and scope of men­tions online regard­ing your key terms will help you cre­ate the busi­ness case for social media adop­tion (or not) by your orga­ni­za­tion, and deter­mine the resources you will require.

If you are inter­ested in the “5 Keys to Social Media Imple­men­ta­tion” and the “Social Media Adop­tion Matrix”, please see the full deck on Slideshare:

social media, brand mon­i­tor­ing, strat­egy, imple­men­ta­tion, mar­ket­ing, online men­tions, phar­ma­ceu­ti­cal, pharma, her­ceptin, avan­dia

tl;dr: First post in a series sum­ma­riz­ing the “5 Keys to Imple­ment­ing Social Media” pre­sen­ta­tion, start­ing with “The Social Media Adop­tion Matrix“

Check­point Char­lie, Berlin, and the pharma indus­try

The recent Eye­For­Pharma eMar­ket­ing Sum­mit 2010 was held in Berlin, a fit­ting place to talk about social media for the phar­ma­ceu­ti­cal indus­try. The Mauer Museum at Check­point Char­lie exhibits the many ways civil­ians and sol­diers attempted to escape from East Berlin. By air, land and sea, peo­ple tried to cross the bor­der by every con­ceiv­able method, includ­ing light air­craft, bal­loons, ziplines, hid­den com­part­ments in cars, under­wa­ter propul­sion, and so on. Their imag­i­na­tions were lim­it­less in break­ing down that great bar­rier to com­mu­ni­ca­tion, the Berlin Wall.

This was my sec­ond visit to Berlin; I love the energy and cre­ativ­ity with which the city rein­vents itself, as it dis­tances itself from the past. Pharmaceutical firms and reg­u­la­tory agen­cies must also rein­vent their com­mu­ni­ca­tions prac­tices as quicker and eas­ier to use tools allow physi­cians and patients to pub­lish to vast audi­ences online.

The Social Media Adop­tion Matrix

At the Eye­For­Pharma con­fer­ence, I pre­sented “5 Keys to Imple­ment­ing Social Media.” If you’ve been tasked with look­ing into social media for your com­pany, this is a sug­gested frame­work to help you define the busi­ness case and strat­egy, deter­mine resource require­ments and allo­ca­tion, and set inter­nal con­trols and per­for­mance metrics.

Let’s start with the adop­tion matrix. In short, it’s a rep­re­sen­ta­tion on how active your com­pany and your cus­tomers are in con­ver­sa­tions online. The hor­i­zon­tal axis plots how engaged your cus­tomers are about your com­pany and related prod­ucts and ser­vices; the ver­ti­cal axis plots how aware your com­pany is of the social media activ­ity sur­round­ing your brand, prod­ucts, ser­vices, com­peti­tors, and indus­try. In other words, are peo­ple talk­ing, and where do you fit in the conversation?

First quad­rant: The Mar­ket­ing Neanderthal

Nean­derthals and mod­ern humans were con­tem­po­ra­ne­ous species, co-existing with Cro-Magnon in Europe for about 10,000 years. Despite their larger phys­i­cal size and brains, Nean­derthals are believed to have expired due to behav­ioral and cul­tural traits not shared by their more suc­cess­ful rivals.

Are your company’s mar­ket­ing efforts floun­der­ing while your com­peti­tors achieve mile­stones online? Are you aware of your customer’s online con­ver­sa­tions about you, if they exist? If your com­mu­nity is not active, do you under­stand the trade offs you’re making?

Most hos­pi­tals (some excep­tions here: Hos­pi­tal Social Net­work List) and edu­ca­tional insti­tu­tions fit in this quad­rant, with nei­ther the inter­est nor resources to devote to research­ing how to develop and con­nect with their com­mu­nity online. How­ever, they are mean­ing­ful spaces which are poten­tially rich with conversations.

Sec­ond quad­rant: The Wise Monkeys

So you sus­pect your cus­tomers are engaged in con­ver­sa­tions about your brand, prod­ucts, ser­vices, or cus­tomer ser­vice online, but you’d rather turn a blind eye? Maybe only Apple can get away with that, and only while their prod­ucts rock. At least they no longer sue leak­ers. But Inter­net bas­tions Google and Ama­zon paid their dues recently. Motrin too.

What about Nestlé, who was absent from the con­ver­sa­tion, and then showed snark? Here’s a sum­mary, from ime­di­a­con­nec­tion:

Now, by all accounts it was Green­peace that “started it” – with the cre­ation of a snarky viral video (more on that in a moment).  Then, enter Nes­tle legal claim­ing trade­mark infringe­ment and ask­ing that the video be taken down.  This resulted in a fairly coor­di­nated protest (some have called it attack) on Nestle’s Fan Page.   Then, Nes­tle cer­tainly didn’t do itself any favors – with a few ham fisted responses.  Help­ful Safety Tip to every cor­po­rate PR / Social Media Man­ager: delet­ing com­ments, or whip­ping out the “copyright/intellectual prop­erty” jus­ti­fi­ca­tions are the social media equiv­a­lent of “let them eat cake”.

But, here’s the inter­est­ing part, whether you believe them or not, Nes­tle did respond to the Green­peace report by “assur­ing” every­one that they will not use Palm Oil pro­duced by the ven­dor that Green­peace is asserting.  Why they aren’t doing this more vocif­er­ously on their Face­book Fan Page is some­thing of a mys­tery.  Green­peace then responded that their con­ces­sions “don’t go nearly far enough”.

Their con­clu­sion is stun­ning:

But I won­der if, after a few more of these types of storms, we won’t see cor­po­rate brands tighten up and kill off some of the social media channels.   One thing I do know (and I’m not say­ing this about the Nes­tle case in par­tic­u­lar) is that as prac­ti­tion­ers we are going to have to start to call bull­shit on the mob as often as we do the mobbed.  Just because they’re out­side some company’s walls with pitch­forks doesn’t mean they’re right.  Or does it?

You guessed it: cor­po­rate Wise Mon­keys see no evil, hear no evil, and speak no evil. Check off quad­rant two of the social media adop­tion matrix.

Third quad­rant: The Pris­oner; The Thinker

Ok, so you know there’s some­thing going on, and that you might tap into the poten­tial of find­ing or devel­op­ing or con­nect­ing with your com­mu­nity online. Unfor­tu­nately, you’re held in check, a Pris­oner to your company’s restric­tive poli­cies, per­haps set in place by an overzeal­ous legal department.

For instance, how many insti­tu­tions block every­one from Face­book, like the high school I grad­u­ated from (many eons ago)? Not even the school’s admin­is­tra­tion is allowed access the plat­form that their stu­dents are so obvi­ously using dur­ing the school­day on their iPhones. Or what about Lehman Toy­ota, where I had my car ser­viced last week­end? I had many hours to spare while I waited, so I brought my lap­top. The dealer had three locked wi-fi sys­tems and informed me and another cus­tomer that access was indeed restricted. Gra­ciously, a man­ager offered to hook us into landlines.

To their credit, AstraZeneca is try­ing out dif­fer­ent social media plat­forms. The Nex­ium Face­book page and their AZHelps Twit­ter account are still a far cry from com­mu­nity man­age­ment. Of course, part of the blame sits with the FDA (see this), which has not set out social media poli­cies for the phar­ma­ceu­ti­cal industry.

“Thank you for all the recent com­ments! We are in the process of review­ing and post­ing them. We’ll have some new dis­cus­sion top­ics shortly and in the com­ing weeks.” -Nex­ium on Facebook

The Thinker, on the other hand, suf­fers from paral­y­sis by analy­sis, read­ing a lot about social media and attend­ing con­fer­ences, yet not tak­ing actionnable steps. 5 Keys to Social Media out­lines a clear roadmap for imple­men­ta­tion. Which com­pa­nies are over-rationalizing social media? Here’s an inter­est­ing post com­par­ing Ford (which “gets it”) with Chrysler. There’s a lot of room for improve­ment, there.

Fourth quad­rant: The Pioneer

Many brands across many indus­tries are actively engag­ing their com­mu­nity online. Kudos for tak­ing the lead and show­ing the way for oth­ers to fol­low, and case stud­ies abound high­light­ing emer­gent best prac­tices. Mash­able and Read­WriteWeb are good places to start for reg­u­lar cov­er­age of social media suc­cesses and fail­ures by big brands and small.

Where does your orga­ni­za­tion fit on the adop­tion matrix? And where do you fit?

A warm word of thanks to Brett Petersel for retweet­ing (@brett) this pre­sen­ta­tion many times, dri­ving it to thou­sands of views in under a week. The full deck is on Slideshare:

social media, adop­tion matrix, imple­men­ta­tion, strat­egy, busi­ness, mar­ket­ing, process, berlin, pharma, phar­ma­ceu­ti­cal

	Mitch Lasky Bench­mark Cap­i­tal Mitch Lasky has spent more than two decades in the mobile gam­ing, new media and inter­ac­tive enter­tain­ment busi­ness. Prior to join­ing Bench­mark Cap­i­tal, Mitch served as exec­u­tive vice pres­i­dent of Mobile and Online at Elec­tronic Arts. Pre­vi­ously, he was chair­man and chief exec­u­tive offi­cer of JAMDAT Mobile, Inc, the lead­ing global pub­lisher of wire­less enter­tain­ment appli­ca­tions, which was acquired by EA in 2005. Prior to JAMDAT, Mitch served as gen­eral man­ager of eCom­pa­nies Wire­less LLC, an Inter­net busi­ness incu­ba­tor. He also spent five years at Activi­sion, most recently serv­ing as exec­u­tive vice pres­i­dent of World­wide Stu­dios. In that role he was respon­si­ble for prod­uct devel­op­ment, busi­ness devel­op­ment and global oper­a­tions. Ear­lier in his career, Mitch prac­ticed law, worked at the Walt Dis­ney Com­pany and started a mas­sively mul­ti­player online game company.
	Mike Trotzke Sprout­Box Mostly, I’m into build­ing things: com­pa­nies, web apps, con­sen­sus, rela­tion­ships. I’ve been lucky to do a lot of what I like. I started my first com­pany while in col­lege. Spun off another one and sold it to a large com­pany. Before that, I trav­eled around mak­ing audio record­ings of march­ing bands and did media for polit­i­cal cam­paigns. I’ve had fun mak­ing money. Design­ing and cod­ing cool web apps is a blast. I’m moti­vated by cre­at­ing things that have value to lots of users. While I’m squarely a geek, I don’t cling to being any par­tic­u­lar type of per­son. I have a very entre­pre­neur­ial mind set and focus a great deal on busi­ness strat­egy, sales &mar­ket­ing, and com­pany cul­ture. I have an awe­some wife, Bets, and an evil cat, Thomas. Not sure why Bets puts up with me or why we put up with Thomas, but we all seem to get along pretty well. My cowork­ers are many of my friends, and I don’t draw a firm line between work and per­sonal life. I’m fired up to meet and help other peo­ple in the spot I was 12 years ago: just start­ing out. Feel free to con­tact me any­time, or stop by the Alley Bar in Bloom­ing­ton any Thurs­day after work. I’ll be there.
	Jolie O’Dell Read­WriteWeb Jolie O’Dell is a tech jour­nal­ist for Read­WriteWeb. She’s been work­ing at star­tups and news pub­li­ca­tions for more than 10 years. She lives in San Francisco.
	Dave Mcclure 500 Hats

Chris Wanstrath, founder of GitHub

Ses­sion:

To get funded at the Pow­er­point stage, you prob­a­bly need to have a track record with VCs. Oth­er­wise you’ll need a func­tion­ing pro­to­type or more, like pay­ing customers.

There are com­pa­nies that shouldn’t be rais­ing ven­ture cap­i­tal, and there are many that aren’t going to get funded because demand far out­strips sup­ply. When you build a busi­ness, ven­ture cap­i­tal should be a sec­ond order con­sid­er­a­tion. Build a solid busi­ness first and think about ven­ture cap­i­tal sec­ond … your busi­ness should not be about rais­ing the money. On the other hand,there are com­pa­nies that do require ven­ture fund­ing, because they do need to get the servers and band­width and employ­ees to be able to scale.

“Don’t write busi­ness plans. It’s a f*ing waste of time” –Mcclure. For Dave, the trust fil­ter is the most impor­tant, and he only con­sid­ers star­tups who have ref­er­ences in common.

Wanstrath did not take Ven­ture Cap­i­tal for Github. It did take a lot of money to set the com­pany up, but they found other ways, includ­ing friends and fam­ily. They made a lot of busi­ness deals for servers, maxed out credit cards and bor­rowed money and gen­er­ally did what­ever it took. They did not feel a $10 mil­lion val­u­a­tion was fair when they were prof­itable mak­ing $1 mil­lion in rev­enues. They cer­tainly did not want to take on a VC that was going to start set­ting their direction.

Lasky sees a lot of great com­pa­nies that are not good ven­ture invest­ments, because the return pro­file does not fit the time or ratios that VCs are look­ing for. For exam­ple, a $500 mil­lion fund will invest in 30 to 40 com­pa­nies and are look­ing at 3X return on cap­i­tal in 10 years. So they’re look­ing for $250 mil­lion exit for all com­pa­nies, or $750 mil­lion with a 2/3 fail­ure rate. Smaller VCs with funds under $100 mil­lion can tol­er­ate smaller exits. An exam­ple would be Mint, which is a com­pany that did need ven­ture backing.

Huge exits are not the median sce­nario by any means and the ven­ture cap­i­tal game has a huge cor­rupt­ing effect on star­tups. A bet­ter approach is to build a cool busi­ness and then things will hap­pen. For most busi­nesses, the core prod­uct can be built by two peo­ple in eight to ten months. This means a $50k to $100k invest­ment, which is not VC; it’s per­sonal sav­ings and friends and fam­ily. The cru­cial seed phase is $250k to $1 mil­lion, where it’s really hard to boot­strap to that size. The best thing to do is to look at VCs with funds under $100M.

The aver­age Tech­stars deal is invest­ing $15k to $30k for about a 7% to 10% stake on a $300k val­u­a­tion — but they bring huge value in their men­tor­ship model. How­ever, this is good for stu­dents out of col­lege, because they have no savings.

The typ­i­cal sce­nario is tak­ing a 20% to 40% dilu­tion when fund­ing through VCs, and prob­a­bly more.

There are plenty of lifestyle busi­nesses online where the founders can make $1 mil­lion to $2 mil­lion per year and live hap­pily ever after with­out hav­ing a big exit plan.

When pitch­ing ven­ture cap­i­tal, you have to sift through the good, the bad, and the crim­i­nally neg­li­gent. Weird term sheets, dis­hon­esty, etc., are the pit­falls to watch out for. Ven­ture cap­i­tal­ists fund the expan­sion of the busi­ness in antic­i­pa­tion of upcom­ing rev­enues. The idea is not to fig­ure out new ways of spend­ing the busi­ness; the fun­da­men­tal con­cept is to spend the money in ways that grow the busi­ness. VCs are will­ing to fail, whereas banks are not.

What are the alter­na­tives to VC fund­ing? What do you do if your friends and fam­ily are broke?

The impor­tant thing about alter­na­tives is that there is no indus­try based around boot­strap­ping, like there is around ven­ture cap­i­tal. First, fig­ure out what you need and then start cut­ting. Do you need PR? Do you need an office? What can you do away with? After that, fig­ure out where you can get the money from. Tak­ing money from par­ents or going into debt is a big deal in case of failure.

A real­is­tic alter­na­tive to boot­strap­ping is rais­ing $100k to $2 mil­lion for up to 20% of the com­pany, with an exit at $10 million.

Q&A:

Euro­pean entre­pre­neurs a decade ago were pissed off about how dif­fi­cult it was to raise money, because of hugh risk aver­sion. The Amer­i­can model of risk is migrat­ing over and things seem to be get­ting bet­ter for Euro­pean startups.

Cus­tomer financ­ing with upfront dis­counts, cus­tomer receiv­able financ­ing or fac­tor­ing, asset-backed leas­ing are some other alter­na­tive strate­gies to help man­age the cash flow and off­set the need for fundraising.

Wanstrath would not boot­strap a con­sumer web com­pany or a con­sumer app.

Wanstrath advises open­ing up as many dif­fer­ent rev­enue streams as pos­si­ble. Offer peo­ple many dif­fer­ent plans and ways to pay you for your services.

For Lasky, the dif­fer­ence in being there six months early meant a $400 mil­lion advan­tage in val­u­a­tion over the sec­ond mover in his market.

The ven­ture cap­i­tal indus­try has to con­tract. There are too many firms with very mediocre results. Part of the rea­son is there are more mature com­pa­nies doing deals earlier.

If you have 20% equity in your startup and are look­ing for a $10 mil­lion pay­out, then your sweet spot for exit must be around $50 to $75 million.

whoneedsvc, ven­ture cap­i­tal, boot­strap­ping, fundrais­ing, startup, finance, busi­ness plan, sxsw, sxswi

This is a live post from a SXSW round­table on ER 2.0, March 14th, 2010

Hos­pi­tals and health care providers are slowly but surely using new media and social net­work­ing soft­ware for some of their pri­mary objectives–treatment, research, edu­ca­tion and out­reach, and patient-provider com­mu­ni­ca­tion. This pre­sen­ta­tion will fea­ture best prac­tices from case stud­ies and pre­scribe future uses of new media in pub­lic health.

Ed Ben­nett Uni­ver­sity of Mary­land Med­ical Cen­ter Ed Ben­nett man­ages web oper­a­tions at the Uni­ver­sity of Mary­land Med­ical Sys­tem (UMMS).He has over fif­teen years expe­ri­ence work­ing on the Inter­net, and has worn many hats ’ pro­gram­mer, designer, con­sul­tant, infor­ma­tion archi­tect, start-up par­tic­i­pant, etc. Since 1999 he has led the Med­ical Sys­tem Web pro­gram build­ing out large, content-rich web­sites designed to edu­cate and attract new patients. His cur­rent focus is the grow­ing use of Social Media and its poten­tial impact on health care. Ed main­tains the Hos­pi­tal Social Net­work List, which tracks the social media activ­i­ties of over 500 U.S. Hospitals.

Aimee Roundtree Uni­ver­sity of Houston-Downtown

Also pan­elling is Jen McCabe of Con­ta­gion Health.

How does this tech­nol­ogy com­pli­cate HIPAA compliance?

There’s a say­ing: “Don’t say no, just say HIPAA.” There’s a lot of fear and trep­i­da­tion around what might hap­pen, but best prac­tices are emerg­ing from those providers who are exper­i­ment­ing first. For exam­ple, some have writ­ten com­ment­ing poli­cies that pro­tect them, and so on.

The involve­ment in physi­cians in the social space is dis­ap­point­ing. They have a dis­in­cli­na­tion toward trans­parency because of the tra­di­tional patient — physi­cian rela­tion­ship that has been ingrained since med­ical school.

Why are hos­pi­tals so slow to adopt social media?

Cross­ing into the space where patients have direct online inter­ac­tion with their physi­cian is still a long way away, because of secu­rity issues. How­ever, when deal­ing with hos­pi­tals, it is a mat­ter of show­ing them how much good is pos­si­ble by using social tech­nolo­gies. We don’t remu­ner­ate doc­tors for inter­act­ing with patients in this way. Also, we are legally bound by reg­u­la­tory bod­ies, and these social chan­nels must com­ply with reg­u­la­tions as well. Twit­ter feeds are admis­si­ble in court.

One of the heav­i­est “things” to move is human resources. For exam­ple, the ques­tion of who is the per­son or peo­ple who are going to address “the tidal wave” of com­ing complaints.

The real-world expe­ri­ence is that 99% of com­ments are pos­i­tive or neu­tral, and there are very few com­plaints: “the unex­pected out­comes of social media for hos­pi­tals will be pos­i­tive, because we’ve antic­i­pated all the neg­a­tives” — Lee Aase, Mayo Clinic. Mon­i­tor­ing is the first step to under­stand how much is neg­a­tive, how much is pos­i­tive, where are the reported vari­ances, and who is doing the talk­ing. One of the most effi­cient means of com­mu­ni­cat­ing is to attach a face to an insti­tu­tion, and to add 10% to 20% per­sonal tweet­ing into these accounts. Exam­ples are Scott Monty of Ford and Frank Elia­son of Com­cast. By the way, it’s great to get neg­a­tive feed­back, because that high­lights what needs to be changed. Lia­bil­ity poi­sons the envi­ron­ment, but fewer law­suits arise when peo­ple treat peo­ple like peo­ple, rather than with­hold­ing infor­ma­tion.

What are victim’s rights online?

The place to start for patient advo­cates is with sys­temic advo­cacy for patient rights in gen­eral, so peo­ple start to trust you over time on a case by case basis.

What are the agents of change in hos­pi­tals and who should we work with?

Under­stand who holds the bud­gets and who is involved with patient care. Under­stand their com­mu­nity engage­ment strate­gies in the real world and show them par­al­lels online. How­ever, under­stand also that it is too early to prove that social media changes behav­ior, so it’s chal­leng­ing to legit­imize these tools.

What about com­pat­i­bil­ity with hos­pi­tal systems?

Hos­pi­tals use lots of sys­tems that don’t talk to each other. Some hos­pi­tals are block­ing Face­book access, for instance, whereas patients are using Face­book to talk about the hos­pi­tal. The imple­men­ta­tion of EMR is address­ing this to an extent and dri­ving a change in behav­ior. Ven­dors need to adopt open source stan­dards and look at inno­va­tions like microsyn­tax and HL7 from MIT.

What about com­mu­ni­cat­ing with patients through mobile devices, par­tic­u­larly for improv­ing the cus­tomer ser­vice expe­ri­ence? By the way, hos­pi­tals pro­vide the most opaque and worst cus­tomer ser­vice experiences.

Some hos­pi­tals and sur­geons are using Twit­ter to pro­vide updates dur­ing an oper­a­tion, after waivers are signed. This way patients’ fam­i­lies can be kept up to date dur­ing the hours of wait­ing. It’s a small but impor­tant step in cus­tomer satisfaction.

In Africa and the Philip­pines, social media adop­tion is increas­ing because social tools are the most inex­pen­sive to use for com­mu­ni­ca­tions, com­pared to legacy or tra­di­tional systems.

The devel­op­ing world is dri­ving inno­va­tion out of need. Maybe the answer in devel­oped nations is to iden­tify orga­ni­za­tions like freelancer’s union, iro­bot, and oth­ers, that have an incen­tive to dis­rupt the health­care sys­tem. Just build really awe­some stuff and you will start to see behav­ior change and integration.

We already have  a well devel­oped social media strat­egy, but our chal­lenge now is to get the physi­cians engaged. Is this even possible?

Hire for that. Find physi­cians that are already blog­ging. Find a leader that sets the exam­ple. Find some­one that oth­ers will follow.

What about cri­sis communications?

If as an insti­tu­tion you start to com­mu­ni­cate and to tweet, then you start to become the source of truth (rather than the media or some­one else). Go through @swhealthcare’s Twit­ter account to under­stand how they responded to crisis.

One of the best ways to drive change is to demand it as the health­care con­sumers we all are.

What tools are miss­ing? What are the new trends?

One big trend is cura­tion of health infor­ma­tion, which is grow­ing at an astro­nom­i­cal rate. Demand will never match sup­ply, so cura­tion is absolutely key.

er20, sxsw, sxswi, social media, health20, health, hos­pi­tals, health­care providers, social net­works

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