Meet @polarwisdom - A Case Study (PDF)

MEET @POLARWISDOM
a ground zero glance at building the
ﬁrst condition-speciﬁc, collaborative
advocacy Twitter feed
an OrganizedWisdom Health project

Monday, April 6, 2009

METHODOLOGY, DECK:

JEN MCCABE GORMAN
• Chief Patient Advocate,
OrganizedWisdom Health

• Cofounder, NextHealth
(NL)

• Medical Education Evolution
(Ning)

• Tweet all about it


THE FINE PRINT
• CreativeCommons • butyou must attribute: Jen
Attribution = McCabe Gorman,
Noncommercial-Share Alike OrganizedWisdom Health,
3.0 Unported 2009

• this means you can share it... • if you alter, transform, or
(copy, distribute and transmit build on this, MUST
and remix it) distribute under same/similar
license
• for NONCOMMERCIAL
purposes (shared for the • questions?
greater good people, don’t jmccabegorman@organized
you feel all warm and fuzzy?) wisdom.com

“WHAT ARE THE BENEFITS OF
SOCIAL MEDIA FOR HEALTH?”
if you’re asking yourself this question, your social
media efforts are destined to fail...


THE RIGHT QUESTION(S)
• what are the beneﬁts of a SPECIFIC SOCIAL MEDIA tool/site/
service for the health of MY userbase/audience?

• (um, who IS my userbase/audience?)


HOW TO FIND YOUR SOCIAL Don’t assume you know how users/

MEDIA HOME consumers are talking about the
space you want to address.

GO FISH! Find out what terms they’re
using, what slang, and how often
this shows up in search! results!

• we knew we wanted a depression-oriented initiative, with
bipolar focus

• did web searches using 3 keywords: depression, bipolar (BPD),
and major depression (MDD)

• searched using Twitter, Facebook, YouTube, Flickr, Google,
Google Blog search

• ‘depression’ with most results (2x), bipolar second most
‘popular’


ALSO ASK YOURSELF...
engage across professional forceﬁelds?

• how does X social media tool/site/service help connect
patients and providers? (Myca/HelloHealth)

• or does it connect providers and providers? (Sermo, Ozmosis)

• or people who are patients and people who are patients?
(PatientsLikeMe, CureTogether, SugarStats, TuDiabetes)


OBLIGATORY
GENERALIZATION
• Health and medical ‘tweets (people who use Twitter regularly)
including both providers and patients, are increasingly using
Twitter to converse about illness, injury, treatment, and
recovery. Good opening slide to break
beneﬁts of social media channel
‘gently’ to the rest of your
organization.

Be diplomatic when introducing
these channels. No one wants
to feel late to the party.


OUR ‘PREHISTORIC’ STRAGEGY
• launch “PolarityWisdom” feed (1.15.09) - begin tweeting (Jen
+Emily)

• announce feed on Twitter (Jen, Unity at personal feeds
@jenmccabegorman, @unitystoakes, and Unity at OW feed
@organizedwisdom)

add self-identiﬁed depression, bipolar, psych, mood, health/
•
medical tweets to follower list

• try to recruit external doc; decided to go with our Medical
Director Dr. Scott Pearlman

• after action review = ask Twitter community for feedback

WHAT WILL IT DO?
“You’ll be able to read the latest doc-reviewed content from
OrganizedWisdom Health related to depression, but
you’ll also be able to take quizzes and share other resources.”


@POLARWISDOM
0-400 followers in less than 8 weeks


NICE TO TWEET YOU.
let’s take a closer look at how


WHAT QUESTIONS DID WE
HAVE?
how many Twitter feeds do we need? (depression, bipolar, MDD)
•

what content do we use (already available WC?)
•

how do we get followers/who do we want to follow?
•

who’s responsible for care and feeding?
•

how are we gonna do this (process)?
•

what type of stuff should we be tweeting?
•

how should we skin it? special design?
•

how should we make it interesting, authentic, valuable, yadda yadda?
•


OUR SOCIAL MEDIA SOUL
SEARCHING
beneﬁts of using Twitter to connect with our
OrganizedWisdom audience?


WHO IS OUR AUDIENCE?
WHAT DO THEY DO?
• “our audience is anyone searching for health information. It is
self-segmented by search topic/WC/category. They segment
themselves, but if they are searching they are our audience.”

• Quantcast.com for details on current demographics


HEALTH 2.0 = ?
• content+community

• health content = forming partnership, conversation, between
patient and provider, or patient and patient, or provider and
provider, or well...

• yeah. it’s a community thing


WHAT KIND OF CONTENT?

• where is most need for advocacy - light in the tunnel tweeting?

• mental illness/mood disorders - stigma

• depression does not deﬁne you


TO TWEET OR NOT TO
TWEET....
ﬁrst, we aim to reduce stigma attached to living w/conditions. If
you’re a cancer survivor, you’re celebrated.
If you’re a survivor of a depressive illness, you’re
derided.


DEPRESSION IS A PART OF
WHO YOU ARE.
IT DOES NOT DEFINE
YOU.


YOUR GOALS.
OUR TWITTERFEED.


WHAT I TWEET
@POLARWISDOM
• twitter helps reframe healthcare research, news and content in
terms of personal, n=1 context

• how does this news/journal article impact me if I have bipolar
depression (or know someone who does?)

• what kind of resources are available for caregivers? survivors?

• what is the latest research on medication development, clinical
trials, and side effects?

• how do I advocate for myself by learning more about my
condition?

“DEPRESSIVE ILLNESSES ARE OFTEN TREATABLE,
MANAGEABLE CONDITIONS.

THIS FEED IS ABOUT SELF-FULFILLMENT IN THE FACE
OF DEPRESSION -

ABOUT LIVING WITH THE CONDITION RATHER THAN

GIVING IN.”


WE WANT TO ADVOCATE FOR YOUR PERSONAL AND
PROFESSIONAL ADVANCEMENT.
DEPRESSIVE DISORDERS ARE MANAGEABLE ILLNESSES
FOR 70-90 PERCENT OF PATIENTS.
IT DOESN’T HAVE TO COMPLETELY TAKE OVER YOUR LIFE.


WE ALSO WANT TO GENERATE DISCUSSION.

YOUR EXPERIENCES CAN BE GENERATIVE FOR OTHERS.

WE WANT THIS COMMUNITY TO SUPPORT
LIFE GOALS THAT INTEGRATE A
TREATMENT-CENTRIC, RATHER THAN AN
ILLNESS-CENTRIC, APPROACH.


YOU CAN ALSO “REQUEST
WISDOM”
BY SENDING A DM TO
@POLARWISDOM.
OUR PRODUCERS WILL CREATE CONTENT BASED ON
YOUR SPECIFIC NEED.
AFTER IT’S APPROVED BY OUR MEDICAL TEAM, WE’LL
PUBLISH IT ON @POLARWISDOM.


AND THE PRICE?
gratis


WHY USE THE
TWITTER COMMUNITY?


SHORT+SWEET


PATIENTS RELATE, IN BRIEF,
SUBJECTIVE IMPACT
LIVING WITH DEPRESSION
HAS ON LIVES,


PUBLIC+PRIVATE


@POLARWISDOM EMPHASIZES
CONVERSATIONAL ASPECTS OF LIVING
WITH DEPRESSION USING TWITTER,
A COMMUNITY FORUM FOR PERSONAL
UPDATES WHICH SUPPORTS RECOGNITION
OF THE CATHARTIC EFFECTS OF
TALKING (AND TWEETING) ABOUT LIVING
WITH DEPRESSION.


GOOD = ADVOCACY FOR
BPD


BETTER = EVIDENCE BASED
APPROACH


cognitive
reframing

OUR TWITTER APPROACH MIRRORS
THE CLINICAL APPROACH
“BRIEF SOLUTION ORIENTED”
TREATMENT -
FOCUSED ON WHAT YOU CAN DO NOW
TO
MAKE YOUR LIFE BETTER.
Consider real-world, brick and
mortar care when designing your
social media strategy.

Our Twitterfeed @polarwisdom
approach (and all our
TwitterWisdom accounts in fact)
are based on ACTUAL CLINICAL
TREATMENT MODALITIES in
behavioral health.


Depression tends to be an episodic,
isolated illness, with signiﬁcant time
spent alone.

Twitter is a 'safe' at-will forum to share
personal, subjective information about
living well with depression.

It's experiential narrative, shared, in
short, soundbite format.

Journaling, for example, may feel to
intense for someone in the throes of
mania. A tweet, however, is easy to ﬁre
off.

IN OTHER WORDS...
if tweeting about something you’re dealing with helps you get
through the day, @polarwisdom wants to help you do that.


WAIT A MINUTE...
this would work for more than just the BPD community, right?


TWITTERWISDOM MISSION
TwitterWisdom is an internal initiative, composed of
various condition-speciﬁc accounts, to use ‘real time’
social media tool Twitter.com to promote healthy living
by populating a daily tweetstream with news, links, commentary,
quizzes, quotes, research, and WisdomCards


Although Twitter.com may seem like a very broad-
spectrum qualitative tool, OrganizedWisdom is a
very metrics-oriented organization.

Our ROWE (all-virtual) work environment means
our team is used to communicating very
effectively using social media and web-based
tools.

This isn't just a “feel-good, slap up some content”
feed - we have developed quantitative
performance metrics for TwitterWisdom.

2 TYPES OF CONTENT
internal+external


WHERE TO GET FODDER
• INTERNAL: WisdomCards

• INTERNAL: HealthCenter

• INTERNAL (hot!): quizzes, slideshows, FAQs

• EXTERNAL: Event - staff member attending? livetweeting?

• EXTERNAL: Blogs (also internal)

• EXTERNAL: Tweeted links

• EXTERNAL: News/current events

GREAT, BUT...
HOW DO I KNOW
WHAT TO TWEET?


5S THEORY OF
CONTENT SHARING
• skip = move on to next one The 5s Theory of Content
Sharing.

March 2009 by Rajesh Setty,
quot;Life Beyond Codequot; blog.
• scan = look for highlights, move on You want to hit the spread -
where people are touched quot;so
much they voluntarily spread it
for you.quot;

• stop = thank you for triggering thinking!

• save = and revisit + times in the future

• spread = share it for you


HOW DO WE TRAIN THE
TEAM?
• TwitterWisdom FAQs (mission, goals, process) V1.0, 2.0 -
composed by Jen McCabe Gorman

• Twitter101 Class (open to anyone in the organization)

• EditorialCalendar review, discussion (monthly phone call, real-
time ATM chats as needed, PlanHQ)

• ‘teaching moments’ using Google chat, Twitter, Bitly

• internal team strategy chat; best practices, examples


Weekly topics that are broad-themed (BPD
and pregnancy) are combined with weekly
features (for example, Monday’s recurring
“things you always wanted to know about” =
tyaw2k).

Then we pull content from internal and
external sources to generate conversation.

DEEP DIVE:
TWITTERWISDOM
EDITORIAL CALENDAR


SECRET SAUCE =
DPSR METHODOLOGY
(data gathering) = reading email, scanning news %
•D

•P (processing) = ﬁnding relevant link %

•S (synthesis) = reading the article, thinking about who’s
interested in this research, where to post it, do I need it %
Pick a link from your
•R (redistribution) = tweet the link % email inbox (say
MEDPAGE). Here’s DPSR in
action...where do you
think you should spend
the most and least time?


DPSR PROCESS SPECIFICS =
A SNAPSHOT
• select content area (internal/external); Ex = WisdomCard

• post link to target WisdomCard using Bitly - shorten,
‘sandwich’ with commentary

• post follow up comment relating to why WisdomCard is
important (weekly editorial issue? hot news? twitter convo?)

• try to ﬁnd news that supports, questions WisdomCard

• tweet news links (1-10) using Bitly


HOW TO ASSESS UTILITY =
QUICK & DIRTY
• if of interest to one of your followers (synthesis), include
@name and comment (cc)

• use TwitterSearch keywords for WisdomCard terms to ﬁnd
tweets who may like related tweetstream (follow, address as
above)


BEST PRACTICE = QUANT
RESULTS

• Dell makes 1M using Twitter...in 18 mos

• Blendtees “Will It Blend?” YouTube campaign drives 5x increase
in sales
EBM is all about
measuring outcomes.
How could a health
organization do any
different using
communication channels?
Without quant support
you make a weak cases.


BENCHMARKS AND PAA
• PAA = pre action assessment (military)

• obvious stats = ‘public face’ - Facebook fans, Twitter followers if
you got ‘em, Digg links, existing web trafﬁc/pageviews

• cloudy stats = your ‘kimono’ - SEO rankings, CrunchBase,
referrals, customer satisfaction, other biz data

• ROI/benchmarks = what are you using now? pageviews?
unique visitors? Goog analytics?


Passive ‘monitoring’ of
Twitter - failboat. But if
you must learn the ropes
silently, please do have a
plan in place to
participate. You’ll be shut
out by signing up and not
updating.

IF YOU’RE INTIMIDATED...
default to tweetstream ‘lurking’


OUTCOMES = ?
engagement metrics. this isn’t rocket science - it’s analytics.


WHAT TO TRACK
basics


OUTCOMES = ENGAGEMENT
METRICS
• followers

• DMs

• RTs

• @replies

• PAGEVIEWS


OPEN GOWN =
HOW WE SHARE DATA
• ﬁrst weekly team strategy • alsoselected quotes, events,
call of the month ‘highlights,’ star followers
EVERYONE gets update on
• ALL ITEMS housed in
TwitterWisdom
public, ‘available to all’
primary staff member working docs hosted in
•
responsible for cloud (Google docs)
TwitterWisdom feed(s)
• anyonecan contribute,
shares followers, DMs, RTs,
anyone can take notes, see
pageviews
exec team feedback


YEAH.
THAT’S GREAT.
BUT HOW MUCH DOES IT
COST?


COST OF DOING BUSINESS:
COUNT IT.
• @organizedwisdom we consider social media participation a
cost of doing business (part of my job description)

• daily COBD line - organizational goal (1/4) = ‘Trafﬁc &
Engagement’

• one primary staffer, support from 3 others (per feed)


Ok. I’m sold. I’ll put a
team member in charge
of t weeting for our org.
But how do I measure her
performance?

WANNA TAKE A PEEK
@PRODUCTIVITY?


PRODUCTIVITY METRICS
= 50 tweets/week, 10 tweets/day (min)
• goal

= 100 new followers/month (min)
• goal

= 4k PAGEVIEWS/month (min)
• goal


HOLD YOUR BREATH:
DEEP DIVE INTO BITLY


THAT’S GREAT.
BUT HOW DO YOU
CALCULATE
PAGEVIEWS?


Using what you
track, manage what
you measure!

We track pageviews
using Bitly.com and

‘ABC’
PAGEVIEW CALCULATION
pageviews/visitor(a) x visitors/tweet(b) x tweets/month(c)


Without ret weets and
conversations, it’s just
about slamming your feed
with links.

We’re working to lower
our ratio of t weets/
responses from 10:1 to 3:1.

NOT JUST ABOUT PAGEVIEWS.
go for link-love via RTs


EASY KEYWORD TRACKING
• Twittersearch/Summize = daily. Org name, staff member(s),
org account, keyword

• Google Insights for search = monthly, prior to team call,
creating editorial calendar

• Google Trends/Analytics= useful for combo terms, phrases
(“organizedwisdom+health2.0+jenmccabegorman”)


MORE FEEDS!
NOM NOM NOM
• http://twitter.com/ow_mental_healt (mental health)

• http://twitter.com/owBipolar (bipolar) We’re also trying
automated ‘s treaming’
update feeds that

• http://owDepression (depression) autopopulate when new
subject-area WCs are
published. Shocker -
these aren’t nearly as
popular; more like
• http://twitter.com/owDrugsMeds (drugs/meds)

• http://twitter.com/ow_womens_health (womens health)


YUM.
BUT HOW WILL IT FEED OUR
BOTTOM LINE?
Roi. Roi. Roi.


THE REVENUE QUESTION
We won't be supporting bits or bytes of
'paid' content or ads on @polarwisdom
(yet) - although we havenʼt ruled this
out.

Outside companies don't pay me to
tweet.

• how does it make money? I tweet for myself @jenmccabegorman
and for OrganizedWisdom.com
@polarwisdom.

• ads?

• sponsorships?

• paid subs?


AGAIN - WRONG QUESTION
Answer = both are vital.

How do you generate
value for users, and for
the company, using a
• pop quiz - which is more important... social media comm
channel?

• PRICING

• VALUE-GENERATION


TIED TO
ORGANIZEDWISDOM MODEL
• feed, designed by President and cofounder Unity Stoakes,
Medical Director Scott Pearlman, and Chief Patient Advocate
Jen McCabe Gorman (with team input throughout!) will act as
a platform for content within a supportive online community

• we, the company, will collaborate with health and medical
organizations interested in supporting the community oriented
feed


BUT HOW WILL PEOPLE
KNOW WHO ‘WE’ ARE?
• decided NOT to ‘require’ employees to have personal
twitterfeeds, so couldn’t use the @naming convention

• use #owﬁrstname to identify tweets/team member

• harnesses existing Twitter convention of using hashtags to
identify events, keywords, etc and track conversations

• @polarwisdom tweets = #owjen, #owemily, #ownicole,
#owamy, #owscott

• team members can CHOOSE to share personal tweetstream
if they so desire, or keep it separate from ‘pro’ tweeting

LAST GASP OF RESISTANCE
but what if somebody says something BAD about us?!


I emailed our team, with
suggested response. Team We had a follower
weighed in. @markhawker let us
@unitystoakes know about a critical
responded in the blogpost from Highlight
comments section. Health.com.
Thanks Twitter, and “OrganizedWisdom:
t weets, for lookin’ out! Much Ado About Very
Little.”

SWALLOW. DIGEST. RESPOND.
love hurts.
so does looking at your org through social media’s collective
gaze.


Twitter is NOT just for
Health 2.0 type
companies!

It’s for patients! It’s for
providers!

BONUS SLIDES
for any docs in the room...or those who love ‘em


MICHAEL LARA MD=
HOW I USE TWITTER
http://
mlaramd.typepad.com/
michael_lara_md/
2009/03/how-physicians-
should-use-twitter.html

• “I’ve found Twitter to be a useful adjunct to my private
practice”

•3 categories: info collection, info sharing, DIRECT PATIENT
CARE

• doc-doc re: non-urgent matters, ofﬁce staff-patient appt.
reminders (gee, that sounds as useful as the Pony Express)


THE GOOD DOC RE: WHAT
NOT TO TWEET

• to communicate directly with patients and their families
(what??)

• to communicate re: ‘urgent’ or ‘timely’ matters (wait, can’t I
choose the channel that reaches me most quickly?)

• to answer inquiries re: ‘details about patient care’


BUT WAIT - JOHN SHARP
SEZ... http://
www.slideshare.net/
JohnSharp/digital-
customer-in-health-
care-1198211

• slideshare presentation “Digital Customer”

• healthcare uses for Twitter = “updating families during
procedures” (slide 14/33)

• also, “emergency communication”


SO WHO DO WE BELIEVE?
and why does the dichotomy matter?


“EVERYONE SHOULD HAVE A
BASIC UNDERSTANDING OF HOW TWITTER
WORKS. EVERY TEAM MEMBER, FOR EXAMPLE,
SHOULD UNDERSTAND THE DIFFERENCE
BETWEEN A DIRECT
MESSAGE
AND THE PUBLIC TIMELINE.
OUR RULE IS TO TWEET ONLY VIA DIRECT
MESSAGES, BUT
ASSUME THAT
THE TWEET WILL BE ON THE
PUBLIC TIMELINE.”

The “Grandma Use” Rule=

If you wouldn’t say it out
loud to your
grandmother, or a
patient’s family member,
you probably shouldn’t
t weet it.

TRANSPARENCY ON TWITTER
via the public timeline


Your team MUST know the
risks and beneﬁts of using a
given social media channel.

And your organization
MUST have a coherent
strategy on transparency of
those communicating on
these channels.

DO NOT ASSUME ANY
TWEETS ARE PRIVATE
DM or no DM...if you remember 2 words about using social
media, remember “public domain.”


“ANOTHER TWITTER TENET IS
UNDERSTANDING HOW/WHEN KEY TEAM
MEMBERS INTEGRATE TWITTER INTO THEIR
WORKDAY.”

CHEWY GOODNESS:
DISTRIBUTE TWEETS VIA
TWEETLATER Or schedule them using
organizational calendar.

I put hour to t weet an
item right onto our
TwitterWisdom Editorial
Calendar.


WHO’S LISTENING WHEN
WE’RE OFF DUTY?
people don’t tweet 24.7.
well, cough cough, MOST don’t... We are NOT treating
people on Twitter, nor are
we recommending
treatment. However, you
should give people access
to a resource that CAN
help treat them (911,
suicide helpline, etc).


After Liz gave this
feedback at
HealthCampPhiladelphia,
that same Friday we
started letting t weets
know who was on
‘weekend on call’ and how
to reach us (via email).

LET FOLLOWERS KNOW
YOUR TWITTER SCHEDULE
via @lizscherer - are you present all the time? Tweet 9-5, M-F?


AND THEY ALL LIVED
HEALTHILY EVER AFTER.
not quite. but this should be the goal of social media for health.


This work is licensed under the
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To view a copy of this license, visit:
http://creativecommons.org/licenses/by-nc-sa/3.0/

Or send a letter to:
Creative Commons, 171 Second Street, Suite 300, San Francisco, California, 94105, USA.


NICE TO TWEET YOU
jmccabegorman@organizedwisdom.com; (w3rk)
jennifermccabegorman@yahoo.com; (lif3)
LinkedIn: http://www.linkedin.com/in/jenmccabegorman
301.904.5136 (m0bil3)


STAY TUNED...
for more on analyzing efﬁcacy, ROI, and tweetstream/pageview
conversion analysis via TwitterWisdom.


Meet @polarwisdom - A Case Study (PDF)

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