american voices - aligned for health

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American Voices – Aligned for HealthGreg Matthews

February 26, 2013

#AVA4H | @chimooseContents are proprietary and confidential.

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My use of twitter allows me to expand the diversity of my

network, and therefore my knowledge in my areas of

interest : prevention, diversity/equity, integrated care, and

Washington, DC (the #epicenter!).

It also allows me to model open leadership as a physician,

and promote this approach among my medical and

nursing colleagues.

Ted Eytan

Family Medicine, Kaiser Permanente

twitter.com/tedeytan

linkedin.com/in/tedeytan

tedeytan.com

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Internet users are searching for health info

Contents are proprietary and confidential.3

72%

140 Million American Adults

Pew Internet and American Life – Online Health 2013

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Self-diagnosis is mainstream


Pew Internet and American Life – Online Health 2013

35%of internet users are

considered “self-

diagnosers”

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Twitter is an information accelerator

• 25% of physicians use social media daily as an information

source*

• Facebook has passed 1B users;

• Twitter has surpassed 500M Users

Contents are proprietary and confidential.

Journal of Medical Internet Research – September 24, 2012

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Tweets Over Time

Trending steadily upward

0

500

1000

1500

2000

2500

3000

3500

4000

4500

1 11 21 31 41 51 61 71 81 91 101 111 121 131 141 151

6 Contents are proprietary and confidential.

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The American Voices study


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AVA4H Data Sets

2.3M

218,934

132,108

36,300*

464,272

71,606

*Journalist-written articles

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5,000

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403,000

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2,300,000

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326,840

Not just tweets this time …

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Making Sense of the Data


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Topical Breakdown

• CDC Disease list

• Broad Health Topics from

Subjects’ tweets

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What we Learned


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At the highest level …


Health Education

Business of Health

Politics of Health

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At the highest level …


Health Education

Business of Health

Politics of Health

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Strongest Focus Areas

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Doctors

Media

Congress

6%

33%

2%

14%

11%

64%

27%

22%

15%

6%

10%

5%47%

23% 15%

Perc

en

tag

e o

f H

ealt

hcare

Co

nv

ers

ati

on

Healthcare Conversation Topics

Treatment

Research

Prevention

Policy

Business

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Where education makes a difference

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Making a comeback


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A new #1

Vaccine-Preventable Diseases

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Doctors armed for combat


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Disease Conversation Volume Over Time

0

10

20

30

40

50

60

70

80

90

100

Diabetes Breast Cancer Prostate Cancer


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The PSA Controversy

117

182

36

Negative Neutral Positive

Doctors who state an opinion are

more than

3:1 Againstthe USPSTF’s

ruling on PSA Tests


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The Voice of the Patient Matters


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Doctors discuss Breast Cancer and Lung Cancer

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Mortality/1,000 Conversation Frequency

Breast Cancer

Lung Cancer

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HIV/Aids and Heart Disease


0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

AIDS/HIV

Heart Disease

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Vaccines - HPVHPV makes up 18.2% of media vaccine conversations

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Doctors

Media

95.8%

81.8%

4.2%

18.2%

Other Vaccine Conversation HPV

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Content Gap Analysis Methodology

• The Content Gap Analysis is

a statistical comparison of

word frequencies between

two corpora of text

• These two corpora are

typically either:

• A subset of one corpus

compared against the

whole corpus

• Two distinct corpora

compared directly

against each other

• The outcome is a list of

words that appear in both

corpora with an associated

“oddness” score that

denotes how much more (or

less) each word appears in

one corpus versus the other

147 documents

1,789 words

Word Frequency

medicine 10

drug 8

vaccine 7

vaccination 7

wellness 6

Word G2

medicine 3.42

drug 2.81

vaccine 1.14

vaccination 1.12

80 documents

917 words

Word Frequency

vaccine 6

medicine 6

drug 4

vaccination 3

health 2

ƒ(x)

Corpus 1 Corpus 2

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Interventions – MDs and the Media

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The untouchable – and the social?

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Medicaid and Mandela

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High Risk/Low Effort

• Doctors discuss 67% more than the media;

• 483% more than congress

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Insurance and reimbursement

• Congress & the media lead the way in exploring how we’ll

pay for care in the future

• Physicians, while concerned about patients’ access to care

and the viability of primary care, can be better informed14%

38%

48%

Doctors

Media

Congress

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Aligning communications – what’s next?

• Patient-centeredness

first

• Create more robust and

transparent networks

(inter- and intra-group)

• Build consensus on the

balance between “most

important health stories”

• Monitor progress with a

public “dashboard”

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Thank you

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Acknowledgements

R&D Lead – Matthew Hager (@iSmashew)

Analyst – Kayla Rodriguez (@Kaylarodrigue11)

Analyst – Dan Zhao (@denzelzhao)

Analytics Design – Seth Duncan (@PRResearch)

Analyst – Emma Ferguson (@EmmaAnAnalyst)

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Appendix

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Physician Profiles

contain a

URL in their

bio

80%

identify

themselves

clearly as

such in their

twitter bio

78%

32%

link to a personal blog

or website


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How are MDs using their accounts?

6.90%

1.90%

31.90%

37.70%

Bio URL Distribution

Business Medical Resource Personal Blog/Website Practice

of all Plastic Surgery

URLs are links to their

practice

93%


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Twitter and the MD Workflow

Morning Workday Work PM Evening Overnight

18% 21% 31% 8% 22%

(0500 – 0800) (0801 - 1200) (1201 - 1800) (1801-2300) (2301-0459)

Localized time

18%21%

31%

8%

22%

0500-0800 0801-1200 1201-1800 1801-2300 2301-0459


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The Connected Physician


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Ratio of following to followers

Ratio of Following to Followers

2.80%4.90%

21.50%

32.40%

16.20%14%

6.70%

1.60%

0.- .1:1 .11-.2:1 .31-.7:1 .71-1.5:1 1.51-3.0:1 3.1-11.0:1 11.1-100.0:1 100.1-2808:1

Median

Ratio

1.1 : 1


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MDs Most likely to be followed by peers*

53%

40%34%

27%

25%

Personal Blog/Website

Business/ Organization

All_Doctors

No Bio URL

practice


*Percentages measure MDs followed by at least 20 others in the data set

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How connected are online physicians?

of all MDs are followed

by at least 20 MDs 34

%

Pediatrics

Emergency

Medicine

Family

Medicine

Specialties who

are followed by

other MDs


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Mining the Data


• Breast Cancer: (breast AND (cancer OR carcinoma)) OR (inflammatory AND

breast) OR (inflammation AND breast) OR (breast AND (metastasis OR metastic))

OR (duct AND (carcinoma OR cancer)) OR (lobe AND (carcinoma OR cancer))

OR "DCIS" OR "LCIS" OR (estrogen AND receptor AND positive) OR "HER2" OR

(breast AND MRI) OR (breast AND biopsy) OR (breast AND ultrasound) OR

"mammogram" OR "mammography" OR "tamoxifen" OR (aromatase AND

inhibitor) OR "exemestane" OR "trastuzumab" OR "Herceptin" OR "lumpectomy"

OR "mastectomy" OR "komen" OR "BRCA1" OR "BRCA2”

• Diabetes: "Diabetes" OR "Mellitus" OR "Insipidus" OR "Diabetic" OR "Gestational"

OR "blood glucose" OR "Blood Sugar" OR "NIDDM" OR "IDDM" OR "LADA" OR

("Antiduretic Hormone" OR "ADH") OR ("Arginine Vasopressin" OR "AVP") OR

"oral glucose tolerance" OR "fasting plasma glucose" OR "glycated hemoglobin

OR HbA1c OR A1c" OR "insulin" OR "SMBG" OR "hyperglycemia OR

hyperglycemic" OR "biguanides" OR "Sulfonylureas" OR "Meglitinides" OR

"thiazolidinediones" OR "alpha glucosidase inhibitor" OR "GLP-1 agonist" OR

"DPP-IV inhibitors" OR "DKA" OR "HHS"

A sample

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Diabetes & Breast Cancer – Sample Search


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