This article was originally published in the January issue of Cardiology Magazine.

By Sheila Sahni, MD , FACC; M. Chadi Alraies, MD; Annabelle S. Volgman, MD, FACC

Social media for health care providers has changed the way we educate and learn and interact with each other. The dynamic nature of social media and its instant availability through our mobile devices is rapidly transforming the way we engage in society. Not surprisingly, the number of social media users is increasing, implying that our patients and their loved ones are on social media. As health care providers, the need to be involved in social media in some way will become part of our responsibilities. A collaborative report by the Pew Research Center found that approximately 77 percent of adults between ages 30 to 49 years and 35 percent of adults older than age 65 years reported using social media in 2015, compared with only eight percent and two percent in 2005, respectively.1 Interestingly, a social media user in 2005 was defined as someone who uses Friendster or LinkedIn and in 2015 it was defined as using Facebook, Twitter or LinkedIn.

Social networking sites are evolving into expansive sources of digital health information for both patients and providers. Whether you realize it or not, social media is going to change the way you learn about new science, ask questions about a clinical case and advocate for your clinical practice or patient. In this article, we’ll help to elucidate how to use social media via Twitter to learn, educate, network and advocate as a member of the ACC.

Why Twitter?

Twitter is a social networking site that allows users to post “tweets” limited to 280 characters and follow users whose content is of interest to them. Every user on Twitter, whether a physician, institution, medical journal, media channel or health organization, is identified by their independent Twitter handle. In June 2017, Twitter had a total of 330 million users, of whom almost 80 percent were outside the U.S. The international sounding board of Twitter far exceeds that of other social media networking sites as it provides over 30 different global languages. While Facebook tallied a total of 2.07 billion users by June 2017, Twitter remains the easiest platform to quickly view what’s being discussed around the world in addition to the users you follow.

A recent study described the volume and content of tweets and the characteristics of Twitter users engaged with discussions about cardiovascular disease in order to examine how Twitter could be used for cardiovascular research.2 For the period of July 2009 to February 2015, a total of 550,338 tweets associated with cardiovascular disease that included these keywords were analyzed: diabetes, hypertension, myocardial infarction (MI), cardiac arrest and heart failure. The study showed that diabetes (n = 239,989) and MI (n = 269,907) were used more frequently than heart failure (n = 9,414).

Users who tweeted about cardiovascular disease were more likely to be older compared with the average Twitter user (mean age, 28.7 vs. 25.4 years, respectively) and more likely to be a woman (8,433 of 17,270 users [48.8 percent] vs. 59,082 of 124,896 [47.3 percent], respectively).

This is an intriguing study and the first to quantify the use of cardiovascular disease-related keywords among Twitter users. The authors illustrated the possibility of identifying the size and level of engagement in U.S.-based cardiovascular disease tweets. More importantly, the size of data available on Twitter is enormous and reflects real-time changes in the discussion of a specific disease topic. Although the use of Twitter for clinical research is still in its infancy, the data has the potential to be used as a platform to improve caregiver and peer support in the setting of cardiovascular disease for challenging cases, management of patients and increasing awareness of prevention measures.

Using Twitter as a Learning Resource – The Learning is Endless!

The easiest way to begin learning on Twitter is by following major medical journals with a high impact factor that you’re already reading. With increasing demands in our professional lives, print journals in our mailbox and lengthy e-mail updates pose small but real challenges for keeping up with new research and clinical updates. On Twitter, you can follow major cardiovascular medical journals in the format of a newsfeed limited to your scope of practice. Given the 280-character limit, the data you read will be succinct and often hyperlinked to more information in a digital format.

For instance, if you “follow” the official Twitter account of the Journal of the American College of Cardiology using its handle @JACCJournals, you’ll receive daily tweets breaking down its newest table of contents into an easy, quick and highly visual format. This feature allows you to stay abreast of new research published in all the JACC journals, including the subspecialty journals: JACC: Basic to Translational Science, JACC: Cardiovascular Imaging, JACC: Cardiovascular Interventions, JACC: Clinical Electrophysiology and JACC: Heart Failure. A simple follow of @JACCJournals may be your new way of staying on top of your weekly journal reading. Similarly, you can find other major medical journals on Twitter and follow their informative tweets.

The power of social media resides in what is called the hashtag (#). A hashtag is placed in front of a term and allows you to search the Twittersphere using the hashtagged phrase, largely like any search tool box in a digital space. Given the expanse of subjects in health care, multiple specialties have created ontology projects in the Twittersphere to help categorize important medical terms related to their field. In April 2016, Robert Jay Widmer, MD, PhD, et al., launched the Cardiology Hashtag Ontology project, creating a list of topics currently “trending” in the cardiology world to organize and streamline searches for ease of use in the digital space for both patients and providers. The list continues to grow and thus far includes topics such as #TAVR, #Statin, #PCSK9 and #AFib. As cardiologists, we can take advantage of the hashtag by adding it to our tweets and continuing to build a digital database pertaining to cardiovascular disease topics. The opportunities for active engagement in learning from these hashtags is endless.

Using Twitter For Virtual Engagement and Networking With the ACC

As a busy cardiologist, Twitter can allow you to have a virtual presence with a broad professional impact. A systematic review of 98 publications that analyzed the role of social media in health care identified four areas of potential engagement for physicians: 1) interaction with colleagues, 2) access to specialized clinical or research-oriented data, 3) surveillance and awareness for public health issues, and 4) influential dissemination of important health care policies.3

ACC’s various social media channels cover the diversity of these areas through: @ACCInTouch – providing clinical updates and @Cardiology for advocacy updates; @ACCCVQuality – providing news on quality, accreditation and registries; and @ACCCardioEd – providing cardiovascular education from the ACC. Additionally, various meetings can be followed virtually by searching a hashtag, such as ACC’s Annual Scientific Session for 2016 and 2017 using #ACC16 and #ACC17, respectively – and soon #ACC18. Whether passively viewing the Twitter feed or actively tweeting live from the meeting or commenting on posted tweets, you’re virtually engaged in the new science being shared at that meeting. Additionally, you can engage directly with thought leaders on Twitter by tagging their Twitter handle in your tweets or replying directly to their posts. The opportunity for continued professional growth can happen virtually through Twitter.

Using Twitter for Advocacy

Advocacy for our patients and clinical practice is perhaps one of the most powerful uses of social media. The ACC has a designated social media channel for ACC’s advocacy efforts, @Cardiology, which is dedicated to health policy news and advocacy action from the ACC. The annual ACC Legislative Conference allows ACC members to meet with their state legislators and share how the health care policies affect patients and health care delivery for all providers.

Our messages as ACC advocates can be reinforced through Twitter, because congressional members and health care policy influencers are on Twitter. Through Twitter, we can directly engage with legislators before, during and after our Legislative meeting. Through retweets and the use of designated hashtags, we can expand our reach and exposure on important issues that affect our patients and our health care practice. Direct engagement with legislators reinforces our advocacy efforts regarding certain public health issues we wish to shed light on or policies we wish to protect or reject.

Social engagement between ACC members and congressional members has been successful through the support of ACC’s Health Affairs Committee and ACC social media staff. The 2016 and 2017 Legislative Conferences held in Washington, DC, featured a break-out session titled Interacting with Congress Through Social Media. This interactive, didactic session demonstrated the use of social media in advocacy and focused on how ACC members can engage with congressional members during their visits on Capitol Hill. The presentation was posted real-time on Periscope, a live-video streaming social media network.

According to Twitter’s analytic data, ACC’s 2017 Legislative Conference totaled over 1,900 tweets from 355 attendees who used the hashtag #ACCLegConf, which generated over 7 million impressions for the entire three-day duration. Regardless of the variety of the tweet content, whether direct engagement with congressional members or a group photo of a local state chapter of the ACC, this form of media by way of the #ACCLegConf handle reinforced and expanded the reach of the ACC advocacy agenda in the digital space.

Whether your interest is advocacy, patient engagement, networking, learning or sharing your clinical expertise, there is space to enhance it on Twitter. Social media has tremendous potential for everyone’s professional career as a cardiologist – and it’s not the future, it’s the present. Social media is transforming how our patients receive information about their health. By becoming active on social media, we can help regulate health-related information while also sharing our own personal, clinical or academic expertise. The integration of social media into the everyday life of cardiologists is an important step towards growing with the digital world and taking control of one’s medical presence in the digital space.

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References

1. Perrin A. Social Media Usage: 2005-2015. Pew Research Center. Available at: http://www.pewinternet.org/2015/10/08/social-networking-usage-2005-2015/. Accessed Jan. 4, 2018.
2. Sinnenberg L, DiSilvestro CL, Manchen C. JAMA Cardiol 2016;1:1032-6.
3. Moorhead SA, Hazlett DE, Harrison L, et al. J Med Internet Res 2013;15:e85.