Dan Diamond, Managing Editor
As opening lines go—well, it wasn't the Gettysburg Address.
And Samuel Morse and Alexander Graham Bell showed much more of a flair for the dramatic.
But five words and six years ago today, an Internet entrepreneur named Jack Dorsey made his own announcement for the ages.
Dorsey had high hopes for his week-old service, then called Twttr. And 500 million users, 100 billion tweets, and a few vowels later, there's no doubt that Twitter has transformed online communication—even in health care, where providers are notoriously slow to embrace Web technologies.
But years after hospitals launched their first Twitter accounts, executives are still wrestling with fundamental questions that would be unacceptable for a traditional service line. How much of an impact does Twitter really offer? And are organizations seeing actual return on investment?
State of the health care Twitter-verse
Roughly 1,000 hospitals—about one-fifth of the nation's total—now have a presence on Twitter.
That's either a major achievement or an ongoing disappointment, depending on which social media expert you ask.
In many industries, multi-million dollar organizations would see services like Facebook and Twitter as fantastic opportunities to connect with potential customers. But hospitals have historically been slow to engage with online platforms—even lagging on webpages in the 1990s—according to Ed Bennett, a social media expert who manages web operations at the University of Maryland Medical Center.
As buzz over social media increased through 2009 and 2010, Bennett did chart a major spike in hospital Twitter accounts but has seen a subsequent leveling off, he told the Briefing.
Strategies to maximize Twitter
The slow adoption rate isn't for lack of opportunity—or reward.
Most hospitals have had a "very positive experience" using Twitter, from improving service recovery to brand monitoring, says Bennett.
Organizations like @MayoClinic and @StJude have even acquired hundreds of thousands of Twitter followers, meaning that every new tweet essentially doubles as a press release, sparking broad conversation and potential media interest.
But many other hospitals have just a fraction of that following, helping contribute to the lull in enthusiasm.
Alicia Daugherty, who works with the Advisory Board's Marketing and Planning Leadership Council, points out several key strategies for hospitals that are trying to maintain vital, active Twitter feeds.
"It’s all about relevancy–the care experience prompts patients to follow the hospital, and then it’s up to the hospital to sustain their attention with interesting, useful content," Daugherty says. She separates hospitals' most engaging tweets into three common categories:
Practical health advice: Daugherty notes this is easy to offer, although Twitter is somewhat saturated with health tips and tricks.
Unusual or counterintuitive information: These tweets can be more interesting, but harder to provide on a regular basis.
Content that sparks a conversation: However, the most active discussions may center on controversial topics–and that's "usually best avoided" for hospitals, Daugherty concludes.
Actively using Twitter also can position hospitals—of all sizes—to better connect with patients, an imperative given the ongoing push for accountable care, says Nick Dawson, Bon Secours Health System's administrative director of physician and community engagement.
"In a capitated risk model, smaller hospitals—which tend to have more constrained finances—may actually have more to gain by using social tools to help control their risk," Dawson told the Briefing. "We're beginning to see social health campaigns and provider-hosted communities which help keep patients in their network"
Locking down ROI
But senior hospital executives may care less about Twitter's future impact and more about its existing track record. Social media experts say they often encounter the same skepticism:
"Sure, connecting with patients is great—but what's the actual return on existing Twitter investments?"
Inova Health's Chris Boyer is determined to find an answer.
As director of Inova's digital marketing and communications, Boyer has instituted a policy where "everything we do"—from launching a new Twitter feed to posting job listings online—"we try to measure," he said. And he's already uncovered strong anecdotal examples of Twitter ROI, Boyer told the Briefing.
For example, a December 2010 Inova Health lecture about back pain was accompanied by an online video stream and live Twitter conversation. At least one person who was following the event on Twitter—and actively asking questions—ended up as an Inova patient within six months.
Boyer notes that Inova's fixed cost of video streaming and live-tweeting the event was about $2,000; adding one neck surgery patient was worth about $20,000.
Lee Aase, who directs Mayo Clinic's Center for Social Media, also has reframed ROI as "risk of ignoring"—his warning that slow-moving organizations may lose opportunities by ceding platforms like Twitter to their more progressive competitors.
Five questions to ask to hone your social media strategy
Social media experts suggest these basic questions for hospitals that are either considering a new Twitter feed—or reconsidering their current commitment.
1. Does someone in your organization have 10 minutes a day to be on Twitter? The service is exceedingly low-cost, Inova's Boyer says, and at this point Twitter's influence is "everywhere," from hashtags on TV to media coverage of individual tweets. Hospitals may increasingly suffer by not being on Twitter, given consumer expectations.
2. Who have you chosen to run the account? Hospitals succeed in social media when delegating responsibility to a staffer who understands the audience's needs, interests and expectations, according to Bon Secours' Dawson. Someone like @danamlewis "excels…[by being] highly empathetic toward providing value to fans and followers. Often that goes well beyond marketing," he adds.
3. Are you looking to bolster your PR strategy? Some hospitals aren't maximizing Twitter's potential to secure media placement, experts say. For example, the Advisory Board's Daugherty notes that PR staff can use Twitter to track journalists’ interests, better tailor announcements to get their attention, and receive early alerts of developing stories to identify opportunities for provider and administrator interviews.
4. How comfortable is your hospital with risk? UMMC's Bennett points out that several of his favorite hospital Twitter accounts, like @DMC_Heals and @fredrkmemorial, stand out because of their playful, personalized banter. But that slightly riskier approach isn't for every hospital, he says, and some organizations prefer anonymous, more structured Twitter updates.
5. Have you already nailed your Facebook strategy? Bennett also thinks that Twitter isn't the best social media for hospitals that are just starting out. "If you have limited resources, put them toward Facebook," he counsels. "The sheer number of prospective patients" who are Facebook members is enormous—and a hospital can eventually use its Facebook feed to promote a spin-off Twitter account.
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Executives on the move