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#ASH17 starts tomorrow and we’ve already seen some 250 health care providers joining the conversation!

Overall, pre-conference engagement is up from last year, and especially vocal are the specialists in Internal Medicine and Hematology (←no surprises there!).  Myeloma is a highly anticipated topic this year with health care providers talking about developments in treatment and diagnostics.

Check out this visual breakdown of who’s talking and be sure to join us at the end of the conference for volume updates and the latest news from thought leaders of ASH 2017!

MDigitalLife

MDigitalLife

Get a deeper look into pre-ASH conversation with MDigitalLife’s interactive network map here: http://bit.ly/2kG6bgR

Over the past several days, we’ve been sharing bits and pieces of an extensive research project into all things “interventional” in preparation for the Cardiac Research Foundation’s Transcatheter Cardiovascular Therapeutics (#TCTDenver) conference, which kicked off Sunday in Denver, CO. Steven Cutbirth’s prior posts are linked below:

While I’ll be making a full presentation tomorrow (November 1) at 1:05PM MDT (Room 501 at the Colorado Convention Center), I wanted to share some of the interesting things we’ve learned about the online behavior of interventional cardiologists and interventional radiologists.

For one thing, it’s not just for the kids – 72% of the online interventionists in our MDigitalLife Online Health Ecosystem database are over the age of 40. They post regularly and actively – more than half of US interventionists post at least weekly, and more than 2/3 of interventionists from outside the US do so.

They use the “open forum” of twitter to debate the topics most important in the field. One of the hot topics I’ll cover in my presentation involves the discussion & debate around TAVR (transcatheter aortic valve replacement), a minimally invasive procedure that can, in some instances, alleviate the need for open heart surgery. The topic is hot enough that there are more than twice as many presentations on this year’s TCT agenda (>131%) as there were two years ago. But the increase in twitter posts over the past two years is even more pronounced: There have been 4.5x as many TAVR-related twitter posts than their were during the year leading up to TCT in 2015 (>441%).

It’s not just what the interventionalists talk about that’s interesting here; it’s also whom they’re engaging in the course of those conversations. One of the most telling signs of an influential online physician is is that she tends to mentioned regularly by her peers. Over the past year, there are literally thousands of interventionalists around the world who’ve connected in conversation – but these are the 10 interventionalists who have been mentioned most often by their peers:

The interventionalists who are responsible for this remarkable growth in meaningful conversation are also convincing their colleagues to join them online at a fast clip. Interventionalists have adopted twitter 14% faster than their brethren in oncology – who are known as active social media adopters among specialists. Two weeks ago, Amit K. Gupta, MD posted an article on TCT’s “Heart Beat” blog entitled Why All Interventionalists Should Be on Twitter. It looks as though his colleagues already agree!

To learn more about how the MDigitalLife Online Health Ecosystem database can reshape the way you interact with doctors, patients, the media & all the important stakeholders of your healthcare company, learn more here.

 

Yesterday, Greg Matthews managing director of MDigitalLife lead a spectacular webinar on understanding physician/patient conversation online. Throughout his webinar he discussed the evolution of online interactions between patients and Healthcare Providers (HCPs) and what healthcare companies need to know to stay ahead of the curve.

Key takeaways included:

  • How to identify and learn from online patients, HCPs and advocacy influencers
  • How to reach patients, HCPs, and advocacy influencers online – safely and effectively – to get your message in front of the right audiences
  • How to leverage social analytics to more effectively launch new products, create custom, targeted content and identify the right KOLs, spokespeople and advocacy partners

If you were not able to attend take a listen to the webinar below.

A little more than a year ago, my colleagues and I started tracking media mentions of drug pricing issues. We assumed it would be an important but relatively laid-back endeavor. Discussions about the cost-savings of hepatitis C drugs was still ongoing, and cancer conferences were putting a spotlight on oncology prices.

Then, on Sept. 18, an intern at USA Today wrote a story about a company no one had heard of raising the price of a drug no one had heard of by an amount no one could have imagined. The headline read: “Company hikes price 5,000% for drug that fights complication of AIDS, cancer,” and it was the first introduction most of America had to Turing.

The name “Martin Shkreli,” Turing’s founder and CEO, never appeared in the USA Today piece, but his obscurity would vanish in a matter of days. Within two weeks, he was being mocked by Miley Cyrus on Saturday Night Live.

The Turing controversy turned our sleepy media-tracking operation into a borderline sweatshop. In the year that followed, we logged 1,300 stories of significance. But not all stories are created equal, so last month, we used our MDigitalLife offering to look at those stories in more detail, trying to answer the question of what pricing/value stories resonated with different audiences: the general public, media and physicians. You can see the results in the infographic below.

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That analysis generated seven learnings:

  1. There is no common source for news. The idea that different groups have different information sources isn’t novel, but the top 10 lists show clearly that while the Wall Street Journal is driving the media agenda (five of the top 10 stories, plus a near-miss for a Pulitzer), it’s not having a similar effect on consumers (zero of the top 10 stories). In contrast, two Huffington Post stories had an outsized impact with consumers, but media and physicians barely noticed.
  2. Physicians are aligned with patients. The stories most-shared by physicians were, in general, stories about the impact of various decisions and policies on patients, not broader topics.
  3. The media are fascinated by the system itself. Most of the top stories among reporters had to do not with a single example but with how the pricing system works from generally, underscoring the complexity, and–perhaps–an instinct toward hating the game, not the players.
  4. Bernie Sanders is a Facebook superstar: Sanders unlikely success in the race for the Democratic presidential nomination showcased the social chops of his supporters. While Sanders wasn’t ahead of the game on any pricing issue, he managed to go viral whenever he inserted himself.
  5. Orphan drugs got a pass. EpiPen, Daraprim and Valeant’s business practices got a once-over in the past year, but drugs for small populations (which tend to come with large price tags) garnered little attention, even as they made up an increasingly percentage of new drugs. That’s a phenomenon that also played out, albeit with some exceptions, with oncology drugs.
  6. Shkreli was catnip. Nearly 2 million people have watched this Vice interview with Shkreli on YouTube, making it one of the most-shared links in our database. First, Shkreli was a news driver. Then he was an icon of generally startling behavior, generating more ink. Finally, he was an all-purpose metaphor for think pieces. Regardless of the role he played, Shkreli was the thread that tied the year’s coverage together.
  7. We’re now in the year of EpiPen. As wild and multi-faceted as the Daraprim story was a year ago, link-sharing behavior around EpiPen stories is unprecedented. How that story evolves will determine in large part where the pricing narrative flows in the year to come.

Our database will continue to grow and inform what we do at W2O Group, internally and for our clients.  We look forward to continuing to listen to conversations in the health care space. Here’s to the next 1,300.

The recent Zika infection of 14 people in a Florida community near Miami – the first case of U.S. transmission from local mosquitoes – has further raised fears that the U.S. will face a large domestic Zika outbreak. With increased news coverage on the domestically transmitted cases as well as the upcoming Olympic opening ceremonies on Friday, August 5th in Brazil, a country hit hard by Zika, there is likely to be a large amount of public discussion about the looming domestic Zika threat.

Studies have shown that physicians are one of the most trusted sources of online health information, so it is likely that patients will be turning to their physician to understand how concerned they should be about Zika and the steps they should take to avoid contracting the virus. But what are physicians saying about the Zika virus?

At W2O Group, we set out to answer that question by querying the MDigitalLife Health Ecosystem Database, the world’s first database to link physicians’ online content to their national physician identifier records, to gain insights into the networks, relationships, and social activities of online physicians.

A Brief Review of Physician Zika Conversation Timeline

Specifically addressing Zika social conversation, there have been over 51,000 posts from more than 4,700 unique physicians since January 11, 2014. U.S. physicians contributed over 29,000 posts from 2,700+ authors and Non-U.S. physicians contributed more than 22,000 posts from 2,000+ authors.

Zika Timeline With Callouts Dark

Physician Zika conversation grew rapidly on January 11th of this year when the first Zika case in the U.S. was reported in Houston, TX. A doctor led the charge with this news as Dr. Umair Shah, Executive Director of Harris County Public Health & Environmental Services, shared the news via his personal twitter account as the news was released to the public. The Houston Chronicle quickly picked up the story (and included quotes from Dr. Hotez), followed by Sarah Begley’s piece in TIME and then similar pieces in nearly every other outlet. Conversation was driven higher on January 16th after Hawaiian officials announced the first baby born in the US with microcephaly linked to Zika and the CDC officially advised pregnant women to avoid traveling to areas where
Zika is spreading. Physician conversation continued to rise on
January 28, when Margaret Chan, WHO Director-General, announced that “the virus was detected in the Americas, where it is now spreading explosively”. Conversation reached its current peak between February 1-3, when physicians posted over 3,300 times after the WHO declared the Zika virus and related links to possible birth defects an international public health emergency.

Watch Monthly Physician Conversation Evolve From 2014-2016 In The Interactive Map Below

ZikaGifAfter global physician conversation peaked with over 15,000 posts in February, conversation began to decline; US physicians maintained an average of 3,400 posts per month while ExUS Physicians contributed an average of 1,700 per month between March and July. U.S. Physicians did see a small uptick in conversation in April when the CDC confirmed the link between microcephaly and Zika. Additionally, there was a rise in conversation in July as the first case of US transmission was announced in Miami. We expect to see a significant spike in global conversation as we approach hurricane season in the U.S. and the Games kick off.

Conversation Over Time

Zika NGram Graph2

We tracked five different keywords throughout the course of the conversation to examine the evolution of the language used by physicians discussing Zika. During late 2015 and early 2016, a significant portion of the tweets contained some mention of “Brazil,” the origin of the outbreak. The volume of tweets mentioning the word “women” was proportional to the overall volume of the U.S. physician Zika conversation, underscoring the relevance of this conversation to women’s health. In April of 2016, tweets started emerging that contained the word “funding,” with many questioning the level of government funding to combat the growing outbreak. July saw the introduction of both “transmission” and “Florida” at a high rate, correlating with many reports examining the transmission of Zika and the rise of domestic cases in Florida.

Going Back to the Start

So who actually started the online physician conversation about Zika? The first post we recorded from a U.S. physician was by Dr. Peter J. Hotez, Founding Dean of the National School of Tropical Medicine, Texas Children’s Hospital Chair in Tropical Pediatrics & President of the Sabin Vaccine Institute, on August 3, 2013. Dr. Hotez’ initial post shared a study released in the Journal, PLOS Neglected Tropical Diseases, which discussed the emergence and spread of Zika in Africa and Asia. The initial post picked up a small amount of traction with four retweets. This did not cause a blip on Twitter’s radar. Though perhaps more people should have been paying attention, since Dr. Hotez proved to be rather prophetic with his post in March 2014 on Zika.

Conclusion and Acknowledgements

Our analysis demonstrates how the online physician conversation about Zika has grown over time, and evolved both geographically and linguistically. It is our hope that monitoring this conversation can be helpful to both physicians and the public at large in keeping abreast of the current issues being discussed in the ongoing Zika outbreak.

This post was co-authored by Dr. Yash Gad, Chief Data Scientist for MDigitalLife.

As a part of a larger research initiative and partnership, we thank our colleagues from the lab of Dr. Wenhong Chen at the University of Texas Austin who provided insight and expertise that contributed to this article.

An earlier version of this post incorrectly stated Dr. Hotez first tweet on Zika was in January 2014.

With the cost of healthcare on the rise, it’s no surprise that players from across the health ecosystem are coming together to solve some of our biggest problems in terms of ensuring access to the right care at a reasonable price. That’s part of the work that Yousuf Zafar, MD has been focused on for the last several years.

It’s should also be no surprise that as leading thinkers like Dr. Zafar grapple with this thorny problem, that one of the tools fueling his research and spreading the results of his findings lies in YZafarsocial media.

Dr. Zafar is a GI Oncologist at DukeHealth and a health services researcher with a focus in improving care delivery for patients with advanced cancer. He has participated in multiple studies focusing on access to care, cost of care, and comparative effectiveness of care delivery between health systems. His primary area of interest is in the cost of cancer care with a special focus on its patient impact. His current work in this arena is focused on patient preferences regarding cost-related communication and decision-making.

Dr. Zafar was a very early adopter of twitter, having been active on the platform since 2007. “I use other platforms personally, but for professional purposes, twitter is definitely the best tool for me,” he told me in a brief interview yesterday. He’s been identified as one of the “Featured Voices” at the ASCO annual meeting in Chicago (#ASCO16), a good choice – the number of Dr. Zafar’s physician followers on twitter puts him in the 97th percentile of all US oncologists. He has been actively involved in the online backchannel of #ASCO16 this far. Below is a map of the physician-to-physician conversations on the first day of ASCO (June 3) – as you can see, Dr. Zafar’s twitter handle (@yzafar) is quite central to the conversation. [NOTE: Click up the number of nodes on the chart to see the full conversation; it’s even more dramatic when you “zoom out.”

That active involvement has resulted in additional visibility for Dr. Zafar and his work – and bringing increasing attention to the issues around healthcare costs is really important to him. “One of the things that has been great to see at ASCO is that we’ve not only been using social media to help connect physicians to the latest research, but also to help patients relate their own stories and experiences to that research,” says Dr. Zafar. In fact, Dr. Zafar tends to learn as much from patients and their experiences as they do from him. “It’s really tough for a clinician who typically only has a few minutes with a patient to truly understand all of the issues associated with their broader experience of care.” Social media has helped to fill that gap.

In one of Dr. Zafar’s abstracts, he summarizes the situation in a very powerful way:

“Long-term solutions must focus on policy changes to reduce unsustainable drug prices and promote innovative insurance models. In the mean time, patients continue to struggle with high out-of-pocket costs. For more immediate solutions, we should look to the oncologist and patient. Oncologists should focus on the value of care delivered, encourage patient engagement on the topic of costs, and be better educated on financial resources available to patients. For their part, patients need improved cost-related health literacy so they are aware of potential costs and resources, and research should focus on how patients define high-value care. With a growing list of financial side effects induced by cancer treatment, the time has come to intervene on the “financial toxicity” of cancer care.”

– S. Yousuf Zafar, MD (JNCI J Natl Cancer Inst (2016) 108 (5): djv370
doi: 10.1093/jnci/djv370)

That shared responsibility for driving change is very consistent with what we’ve seen in the online health ecosystem – the convergence of health conversations among clinicians, patients, caregivers, policymakers, the media and the industry itself. Our thanks to Dr. Zafar for his great work & for taking the time to talk to us. Be sure to follow him on twitter (@yzafar) and in the media.

For more information about the MDigitalLife Online Health Ecosystem and to download the 2016 Social Oncology Project report, just click below.

TheSocialOncologyReport-Cover-HiRes

Click to Download the 2016 Social Oncology Project Report


Learn more about W2O Group:  About  Work  Contact

Over the last several years, we’ve had the opportunity to study several people in the online health ecosystem who play multiple stakeholder roles (e.g., Patient-Peschattnerhysician or Patient-Journalist). Today I’m featuring one of the rare people who actually plays 3 pivotal roles in the online health ecosystem – Elaine Schattner, MD.

When she was practicing, Elaine was highly respected for her clinical acumen. But she’s also a breast cancer survivor and a noted healthcare journalist (she’s a regular contributor at Forbes, among others). This has given her a truly unique perspective on the way that different populations perceive and interact with the healthcare system – and their own health.

The way that Elaine engages online reflects her multiple perspectives – and her broad interests. During calendar year 2015, she mentioned 1,327 unique twitter handles (including at least 171 doctors, 77 patients, 173 reporters and 134 media outlets). She also shared links to 570 different outlets (including sources as diverse as Medscape, Nature, the New England Journal of Medicine, StatNews.com, Brainpickings.com and PeterUbel.com.)

And her audience is equally diverse. Among her more-than 11,600 followers are at least 1,200 physicians (putting her in the 99th percentile of doctors most followed by her US peers) and remarkably over 1,100 patients, caregivers and patient advocacy groups – more than any other US Oncologist. And it’s not just Elaine’s following that’s particularly strong and diverse; she also engages that audience broadly with the content she shares. During 2015, she was mentioned (or her articles linked to) over 3,600 times by nearly 1,000 people and organizations in the MDigitalLife Online Health Ecosystem database. And those engagements reflect her audience’s diversity as well:

  • 42% from fellow physicians
  • 35% from patients, caregivers and patient advocacy groups
  • 10% from reporters and media outlets
  • 13% from people and organizations in the healthcare industry

It’s a rare individual, physician or not, that can reach an audience of that size, breadth and relevance to the healthcare system. What is it that’s makes Dr. Schattner so successful in building and engaging that audience?

“On social media, as in real life, many people – in their social groups, or among colleagues – tend to nod their heads, to reiterate or rephrase what’s popular, or what they think their employer or network will favor. On twitter, that ends up generating a lot of retweets within groups of like-minded followers. But that kind of chatter doesn’t broaden anyone’s knowledge base; it reinforces silos. It’s neither interesting, nor helpful to science, or health, or anything really. I like to add new ideas to a conversation. Otherwise, what’s the point?”

– Elaine Schattner, MD

SchattnerMostFollowersSnapshot-300x203Dr. Schattner has been particularly impactful in the online conversation about breast cancer. Among the tens of thousands of participants in that conversation from the MDigitalLife Online Health Ecosystem, Dr. Schattner is the 3rd most-followed, behind only USA Today healthcare reporter Liz Szabo (@LizSzabo) and #BCSM twitter chat co-moderator Deanna Attai, MD (@DrAttai) – and followed closely by #BCSM chat co-moderator and breast cancer survivor Alicia Staley (@stales). This is even more intriguing, because Dr. Schattner rarely participates directly in the #BCSM chat – a huge driver of conversation in the breast cancer community.

“I don’t often participate in twitter chats. They provide great value for many people, but don’t fit very well with my preferred mode of engagement. I tend to have more one-on-one or small-group conversations. When things move so quickly – as they do in twitter chats, it’s harder for me to be able to do really get to know people and to understand their perspectives.” – Elaine Schattner, MD

The rise of the social media has completely changed the way that the health ecosystem interacts. As health becomes an increasingly important topic in the 21st century, the ability to connect the stakeholders – all of them – is both valuable and necessary. Led by pioneering bridge-builders like Dr. Elaine Schattner, we can be confident that a shared understanding is both possible and on its way more quickly than we could have imagined.

“I’ve always been the kind of person who speaks her mind. I’m not afraid to say and write what I think, and as an independent journalist I am free to do so. I’m not afraid to challenge the opinions of powerful individuals, including physicians in positions of leadership, journalists and others. People know that about me, and maybe some respect me for doing so. Pretty much everything I say, or share on-line, reflects what I think matters for patients. Some may trust me for that reason, even when they disagree.”

– Elaine Schattner, MD

TheSocialOncologyReport-Cover-HiRes

Click to Download the 2016 Social Oncology Project Report


Learn more about W2O Group:  About  Work  Contact

Advocacy in the age of social oncology is no longer about simply “raising awareness” or boosting funding. According to Samantha Watson, who founded the The Samfund after her own experience as a young adult with cancer, those who are battling cancer, and those who did, are clear that they are looking for community and emotional support as much as they are financial resources.

While the analysis of hashtag communities that provided the backbone of this year’s edition of The Social Oncology Project found that advocates have huge influence in drawing attention to high-quality information resources, Watson’s experience suggests that information-sharing is just the tip of what can be accomplished through online networks.

Watson’s primary goal is providing grants; her group has given nearly $2 million to young adults dealing with cancer-related challenges, from medical care to financial assistance for adoption. But Watson said that the Samfund recognizes that they have a role to play in building online communities, too.

Watson discussed the new realities with us in advance of the ASCO meeting; if you want to carry on the conversation, please seek out Watson’s booth on the expo floor:

Samfund is mostly young adults. Is there a sense that this new generation of survivors is connected differently because of technology?

“Social media makes it much easier to reach people we could never reach via traditional media. Peer-to-peer efforts are critical for our fundraising. We have all of these people who are connected to Samfund, and each of them has online networks, so there is a ripple effect. We can share stories, and it’s amazing to see how so many people share them. We couldn’t do that if we were relying on newsletters and emails.

The online community has been huge. Half of our grantees are part of a private Facebook group. Watching them support each other has been huge. Social media gives them a place to assemble.

There will always be some problems that we, as an organization, can’t help with. But with our network, with our Facebook group, there is always at least one person, often more, who can chime in and say ‘I’ve been there.’”

You’ve written about crowdfunding before. How does that element intersect with this new type of communication?

“Crowdfunding is huge for our community. I was treated before social media, but an earlier version of crowdfunding helped me. It was totally lifesaving. When someone you know goes through an illness, the impulse is to ask what you can do to help. But for people who are far away, there hasn’t always been a good answer to the question ‘what can I do?’ That’s changing.

We still have to deal with how uncomfortable asking for money makes people. But that isn’t something that the young adult with cancer has to deal with. Setting up a campaign for someone is a great way for friends or family to help out.”

Are there drawbacks? Does building a national—but virtual—network isolate in its own way?

“We’ve tried really hard to get the best of both worlds. It’s important to have real-world experiences. But having a connection even with those far away is important, too. For someone who is skipping their meds and is geographically isolated, finding a community online is critical. We keep our eye on that a lot.”

What online resources have you or your grantees been able to tap into?

“We send every grantee all of our resources: our webpage and the private Facebook group and Instagram and Twitter. And we ask our grantees to help us out by sharing. We learned at our recent meeting for ‘Sambassadors’ that that is what is most important. In talking to them about what we do, no one mentioned the $1.6 million we’ve given out in grants. Instead, what they kept talking about was feeling hopeful again and feeling confident again, and how that came from being a part of a community.”

Download The Social Oncology Project 2016 here.

Download The Social Oncology Project 2016 here.

Today, we’re releasing the fourth version of our annual report, The Social Oncology Project, a comprehensive review of conversations about oncology happening on publicly facing social media.

Before I note some of the lessons we learned from this year’s report, I wanted to flag how the lessons we’ve learned over the previous three years colored our approach. Our initial impulse in surveying the online landscape was to understand WHAT was being said about cancer. That helped us better understand the ebbs and flows of topics discussed online and impressed us with the pure volume of conversations.

But what we found was that trying to make sense of every last tweet about cancer could be misleading. We found a lot of tweets, but there was a lot of low-value conversation. It was difficult to draw firm conclusions about WHAT was being said without knowing WHO was talking.

So this year, we’ve boosted the signal-to-noise ratio by looking at four specific groups of online influencers who have demonstrated influence and high-quality discussions: doctors, advocates, patients and media. Though the lines between these groups are not always bright, categorizing online voices with more precision offers a more complete picture of what is truly happening in social oncology.

By looking at these four groups, across five different cancer types and two specific topics (immunotherapy and value in cancer care), we’ve gleaned four key truths about the state of the online oncology conversation:

  • Connections > Volume. For every cancer we assessed, we plotted a network graph, showing how every member of the community was connected to every other. What we found was that it wasn’t always the person posting the most that had the most influence: it was the individual whose network knit together the more diverse coalition.
  • Video is King. We also looked at thousands of links shared within hashtag communities. And despite the fact that oncology is not necessarily a visually-driven medium, we saw YouTube emerge time and time again as a site that was frequently shared, especially by patient and advocates. In a world in which we all have video cameras in our pocket, video will only play a larger role in communication around oncology.
  • News Doesn’t Drive Education. When hashtag communities look for new information, they tended to either go right to the source (peer-reviewed publications) or vetted medical information from the government or large cancer centers. News stories drive relative few conversations, suggesting that what’s new isn’t necessarily what is important, especially for clinicians and patients.
  • Doctors Serve as a Bridge to Information. Physicians in the network, across nearly every subject we analyzed, were unique in that they pushed peer-reviewed data out across the network, not watered-down summaries of research. Navigating the scientific literature can be hard—not because non-physicians can’t understand it, but because separating wheat from chaff is not always straightforward—and by directing attention to key papers, physicians play a vital role.

All of this may beg the question of what’s next. Our conversations with thought leaders—some of which are included in the report and some of which will appear on the blog in the days to come—suggest that the next big thing is smaller conversations. Though large, hashtag-driven discussions are not a part of the fabric of online conversations, we’re hearing more about the way that smaller communities can come together for information exchange in private messages, closed Facebook groups or crowdfunding platforms.

While network size will continue to be factor in making sure that the right people find each other, we look forward to exploring a future in which a kaleidoscope of small, interlocked groups drive social oncology to new places.

Download The Social Oncology Project 2016 here

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