Why cardiologists should be on social media – the value of online engagement

KEYWORDS:

• Cardiology
• education
• practice
• social media

1. Introduction

Social media through its inherent quality of personal engagement has changed the way we follow current events, learn about new advances in cardiovascular advancements, and communicate within our personal and professional lives. The dynamic nature of social media with its instant availability through our mobile devices is rapidly transforming the way we engage in society. Cardiologists are always enthusiastic to embrace new advancements in medicine and technology. However, as a whole, they tend to be late adopters when it comes to progressive communication tools such as social media. While many cardiologists consider social media a powerful tool for education and learning, others think it is a liability threat.

2. Social media audience

A collaborative report by the Pew Research Center found that approximately 75% of all adult American utilize social media in some form or another. Furthermore, 77% of adults between age 30 and 49 and 35% of adults older than age 65 reported using social media in 2015 compared with only 8% and 2% in 2005, respectively [1]. Using Twitter or any other social media network, cardiologists can reach outside practice and academic medicine to patients and public, two groups that have traditionally been hard to engage. Every day, the social media networks put thousands of posts related to health care. In recent years, cardiologists started using social media to discuss challenging cases, promote practice, discuss recently published articles, and even interact with patients and peers to ask as well as answer questions [2,3]. Many cardiologists envision social media as extension of the doctor–patient relationship. This is true, since different social media platforms have been used to seek feedback for clinical trial design, device marketing, and even speed enrollment in clinical trial [2]. US FDA’s top priority is to promote greater safety for the patients we serve. Thus, social media has the potential to perform as continuous and instantaneous monitoring tool to provide information on device failures, products side effects, and food toxicities [4].

3. The value of online engagement

Social media has been considered a reasonable vehicle for educators, clinicians, and researchers to communicate and stay connected with each other. Instead of waiting to discuss new research in-person with a handful of colleagues at a conference, social media permit virtual discussion with many professionals across the globe. One study looked at 98 publications that analyzed the role of social media in medicine [5]. The study concluded six defined areas where online engagement proved to be a viable platform. These areas include better interaction with colleagues; better access to information, particularly specialized info; wider access to medical and health information; increased support for patients and from peers; improved surveillance for public health issues; and increased possibility of influencing health-care policies. It is worth noticing that when social media is used correctly, there are many important ways that it can improve the medical field. Not only you can spread information faster and engage in a wider discussion with other cardiologist, but you may also be able to influence public opinion and help shape policies that affect the entire medical field. We must always keep in mind that elected officials are online just as much as anyone, meaning that they can be exposed to new studies and information that they would otherwise ignore.

4. Social media could influence patient outcome

Every user on Twitter whether a physician, institution, medical journal, media channel, or health organization is identified by their independent Twitter handle. Twitter’s ease of use allows patients to ask questions, create community for certain diseases, and seek answers from health-care experts. When patients are involved in these discussions, they are more aware of their disease process and are more likely to make lifestyle changes, be more compliant with therapy, and eventually have better outcomes [6]. One study evaluated the possibility of using Twitter for cardiovascular research and aimed to describe the volume and content of Tweets and characteristics of Twitter users engaged with cardiovascular disease discussions [7]. Briefly, a total of 550,338 tweets from 2009 to 2015 associated with cardiovascular disease were analyzed, specifically those with the keywords: diabetes, hypertension, myocardial infarction, cardiac arrest, and heart failure. The study showed that diabetes (n = 239,989) and myocardial infarction (n = 269,907) were more frequently used. The findings of this study are intriguing since the authors illustrated the possibility of identifying the size and level of engagement in US-based cardiovascular disease Tweets. More importantly, the size of data available on Twitter is enormous and reflects real-time changes in discussion of a disease topic. Although the use of Twitter for clinical research is still in its infancy, the data generated from social media has the potential to be used as intervention to improve caregiver and peer support for challenging cardiovascular cases, educate general public about certain diseases, and manage patients suffering from cardiovascular illnesses [4].

5. The impact of social media on cardiology journal readership and citations

Social media can serve to disseminate original research, guideline statements, cases, images, and review articles that are essential components of journal content. Because of its reach, social media allows medical journals to share content with readership that reaches beyond subscribers to the medical journal. Followers of major peer-review cardiology journals on social media often get access to full-text articles for free [8]. The purpose of this initiative is to increase readership and disseminate findings to parties who are not part of the medical establishment and who would not access or read scientific and medical journals. From metric standpoint, free access to article using social media platform will increase article views and downloads and eventually might promote number of journal citations [9]. Although randomized trials have not been able to demonstrate an increase in the 30-day view rates in the overall population, cardiovascular publications indicate that an important relationship was observed between readership of basic translation of papers and the advantage of social media. Thus, it appears that there is a signal for improvement of provider education and dissemination of knowledge within social media that is immediate and impactful and could potentially influence patient outcomes [10].

6. Limitations of social media

Despite the advantage of being dynamic and accessible to the public, social media has certain limitations in the medical field. In certain instances, it is hard to control the discussions with potential to deviate from the main objective of the post that was published. Different from peer-review process, users do not have to declare relevant conflicts of interest that could give wrong impressions to the public. Last and foremost, the presence of researchers and clinicians on social media is low in comparison with other segments of the population. Thus, there is an urgent need for experts available to review social media material and give their expert unbiased opinion to help the public receive the correct information.

7. Best practice of social media

Compared with mailing address or subscriptions, information on social media can spread quickly without barriers and has a bigger reach. Social media is an open environment with no standard method for sharing information, guidelines for medical communication, or legal restrictions that protect the patients’ privacy. Therefore, physicians have to be vigilant with what they put up on social media. With that in mind, there are some points that physicians have to keep in mind when using social media as summarized in Table 1.

Table 1. Physician Social Media Rules.

Health-care providers’ social media best practice

Strive accuracy

Never identify a patient

Ask permission

Assume beneficence

Expect every message read aloud in court of law

In summary, social media is changing the way we learn new science, ask clinical questions, advocate for clinical practice, discuss science, and share medical opinion. Social media is as powerful tool as we make it. Using social media, we can engage in various interactions in a much easier way than ever before. This can not only help keep us educated but also potentially save lives.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.