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http://regmedia.co.uk/2004/04/07/nigeria_419_shirt.gifIt 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

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Table of con­tents for Keys to Imple­ment­ing Social Media series

  1. Imple­ment­ing social media: the adop­tion matrix
  2. Imple­ment­ing social media: brand monitoring

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

http://img.skitch.com/20100402-x5jb9bgy4xqta1sws7h7khhnpx.jpg“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:

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Table of con­tents for Keys to Imple­ment­ing Social Media series

  1. Imple­ment­ing social media: the adop­tion matrix
  2. Imple­ment­ing social media: brand monitoring

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.

http://img.skitch.com/20100330-p859kyxh3ugbcjmb69qtju4iec.jpg

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:

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This is a live post from a SXSW panel on Ven­ture Cap­i­tal, March 15th, 2010

Only a frac­tion of busi­ness financ­ing comes from Sand Hill Road. Yet entre­pre­neurs still obsess over tra­di­tional big meeting/big money Sil­i­con Val­ley ven­ture cap­i­tal. This heated panel debates what types of com­pa­nies actu­ally ben­e­fit from VC and reviews con­crete exam­ples of alter­na­tives to tra­di­tional ven­ture capital.



Pre­sen­ters
53203_thumb Mitch Lasky
Bench­mark Cap­i­tal
53204_thumb Mike Trotzke
Sprout­Box
53205_thumb Jolie O’Dell
Read­WriteWeb
53206_thumb 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.

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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.

Pre­sen­ters
50882_thumb Ed Ben­nett
Uni­ver­sity of Mary­land Med­ical Cen­ter
50883_thumb 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.

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