Health Reform in 140 Characters

While Congress is abuzz over the prospect of healthcare reform, many in the medical device field are atwitter over the explosion of Internet-powered healthcare reforms already taking root. Regardless of whether Congress passes a public health insurance option, a bent cost curve, or integrated electronic health records, an impressive array of social media tools and disruptive technologies are revolutionizing healthcare. The medical technology digerati would be well advised to keep one eye on Congress while keeping a careful watch on the regulators—FDA and FTC—as social media continues to reform healthcare.

Technology enabled the health industry initially to move from a preInternet, industrial economy to an information economy (in which information was pushed out). Today, the economy could be described as one that emphasizes relationships, characterized by innovative tools that enable companies to build social connections, share information, and collaborate online. Social media affords both opportunities and challenges for medical device companies as these online tools find their way into marketing, communications, research, advocacy, and legal functions within the life sciences.

Social Media and Healthcare

Robin Strongin

Social media uses in healthcare vary. Physicians are increasingly using social networks, replacing the traditional doctors’ lounge with an online, global one. Patients, particularly those with chronic diseases or terminal illnesses, seem comfortable putting very personal information online in an attempt to further research and gain the wisdom of others with similar experiences. Disease groups, like the American Cancer Society have spent millions of dollars leveraging the power of social media to reach a young demographic, build community, and educate and advocate.² 

Researchers and manufacturers have realized that the reach of these tools can expand clinical trial recruitment and foster data arbitrage. Payers, too, have invested significant resources in a variety of tools. Health e-gaming is one such example that aims to empower and educate teens with cancer and to incentivize obese children to exercise and eat healthy (see the sidebar, “Social Media Uses in Healthcare [7].”).

Public health officials have also looked to social media and Internet-based communications channels to cast a wide safety net. In May 2009, the New England Journal of Medicine published a perspective on digital disease detection in which the authors noted that “the advent of openly available news aggregators and visualization tools has spawned a new generation of disease-surveillance ‘mashups’ (Web application hybrids) that can mine, categorize, filter, and visualize online intelligence about epidemics in real time.”³

The federal government has also flexed its social media muscle. CDC was an early adapter of virtual worlds (e.g., Whyville and Second Life), virtually vaccinating tens of thousands of children while teaching them, and their families, about the importance of flu prevention.

FDA has made an enormous investment in widgets, wikis, and twitter feeds to educate a variety of audiences and to keep patients and health professionals up to date on public health issues. FDA has done an admirable job using these Web-based communication feeds, along with social photo and video sharing, during recent product and food recalls. Video is particularly effective—literacy can be an issue for many individuals, and health literacy can be even more challenging. Recently, CDC and FDA teamed up to coordinate online efforts to educate and reassure the public during the recent H1N1 episodes. 

Federal Regulations

It is somewhat ironic that CDC and FDA are integrating the latest in social media to reach a number of audiences, but device manufacturers are not. FDA and FTC have been wary of how these companies would use social media and what to do about adverse event reporting. FTC has jumped into the fray with its Guides Concerning the Use of Endorsements and Testimonials in Advertising [8]. But the lack of clear FDA guidelines has been the source of much frustration. The tide may be changing, however.

FDA held a public hearing [9] to discuss online promotion of FDA-regulated medical products—prescription drugs, biologics, and devices. The hearing took place on November 12–13, in Washington, DC. FDA sought input on 19 specific questions in the following five areas:

• Accountability.
• Fulfilling regulatory requirements.
• Posting corrective information.
• Links.
• Adverse event reporting. 

Although there remains a great deal of gray area when it comes to marketing branded medical products via social media, there are a number of best practices that medical device companies should pay attention to. Medical device companies would be well advised to establish a cross-functional committee (including marketing, human resources, legal and compliance, government relations, and communications personnel) to create and monitor social media policies, establish budgets, keep abreast of regulatory changes, and set best practices (see the sidebar, “Best Practices [10].”).

No matter where your company’s comfort level falls on the social media risk continuum, it is time to start thinking about harnessing the power of social media. 

References

1. Ted Eytan, “The Health 2.0 Definition : Not just the Latest, the Greatest!”  Available from Internet: www.tedeytan.com/2008/06/13/1089 [11].
2. “ACS Unveils $15m Brand Revitalization Campaign,” PR Week (April 27, 2009): 3.
3. John S. Brownstein, Clark C. Freifeld,  and Lawrence C. Madoff, “Digital Disease Detection—Harnessing the Web for Public Health Surveillance,” New England Journal of Medicine, 360, no. 21 (May 21, 2009): 2153–2157.

Robin Strongin, president and CEO of Amplify Public Affairs and creator of the Disruptive Women in Health Care blog (www.disruptivewomen.net [12]).