This case study is the second of a two part series. The information below reflects the events of April 25, 2011 from a tactical standpoint, with critical regard to process and strategic considerations. Part I details the story of April 25, 2011 from a human standpoint.
The dialogue that took place on Twitter between Emory Healthcare and Matthew Browning on April 25, 2011 was a powerful one. Without time to spare, Matthew turned to Twitter in a time of crisis to help get his wife Phoebe’s grandmother transported to a hospital with capacity and capabilities to help treat her ruptured aorta. We were able to assist Matthew and his family in an emergency situation, leading to Phoebe’s grandmother being airlifted within 16 minutes of receiving contact information, a truly amazing feat. Despite this, there are countless lessons learned from the experience. While Part I of this case study explored the story and events of April 25, 2011, this portion focuses on the meaning behind and implications of that story. The whole goal here is to help people; and if that’s truly your goal with social media crisis resolution, there are steps you can take to make that a reality, knowing that there will always be scenarios and circumstances that can’t be resolved with a cookie cutter process.
What’s Covered in Part II
- What we knew before our interaction with Matthew and how that produced the outcome that was achieved on April 25, 2011
- Tactics and qualities we employed as part of our social media strategy
- Steps your organization can take to define its process and strategy
- Things we learned from our interaction with Matthew
- Questions that remain unanswered
Health Care Social Media – What We [Thought We] Knew Then
Prior to our interaction with Matthew on April 25, 2011, we had what I would deem to be a thorough and solid process for mitigating risk and resolving issues over social media. Our process and general process recommendations are outlined below.
Social Media Process Tactics
The tactics used at each organization will differ substantially based on organizational structure. Larger, more siloed organizations will have to work harder to bring together disparate contacts in the time of crisis. Aligning these groups and stakeholders in advance is highly recommended. Below is a listing of core components of our social media strategy at Emory Healthcare prior to our engagement with Matthew Browning.
Evaluate Need for Response
When receiving feedback via social media, before jumping into any process, you must first evaluate whether there is a need for response at all. Many may already deem this item to be common sense, but in fact, it’s not. Not every contact via social media warrants a response, especially not when you’re getting hundreds of them a day. Ask yourself first:
- Does it require a response at all?
- Does it need an immediate response?
- Is it likely that our network will respond on our behalf?
No work in health care or any business is done in a vacuum. Collaboration is key both within the walls of a hospital or clinic, and outside of them. At Emory Healthcare, social media is another realm in which this collaboration continues. We collaborate with direct contacts in several departments who know we rely on them to solve problems over social media. If we get a billing complaint, there’s a contact for that. If someone voices concern over an insurance issue, there is a contact for that. If at any point, we can’t get an answer from one of these contacts, we still take action by letting the individual know we are working on getting them an answer. As soon as we do, we always circle back and follow up.
Continue the Dialogue Offline
When the dialogue gets heavy or privacy becomes a concern, we try to steer the conversation to a more private location. When on Twitter, we will often Direct Message (DM) contact information for the appropriate department so the individual can work directly with them to continue the resolution process. Social media is not an end. It is a means to the end, which is an appropriate source for resolution. It is our job to make the transition from Twitter to telephone, or hospital, or clinic as seamless as possible for every individual.
Identify Common Complaints
You know your health care system better than anyone else. If your most common source of complaint relates to long wait times, or slow billing, you should have on-call contacts to help when those concerns come up. But furthermore, you should communicate those trends in feedback to departments that can directly impact their improvement. Again, Twitter is not an end; it is a piece of a very large and cyclical accountable health care puzzle.
Just like our doctors, nurses, and staff have been trained and are equipped to handle the most severe and/or high-pressure medical cases, so too have our team members behind the scenes who facilitate Emory Healthcare’s internal operational and communications processes. This means that before an emergency ever arises, we have processes in place to guide groups in a decentralized organization to a commonly understood and supported outcome.
Questions to Help Guide You in Defining Your Process
When looking to define your own process, contacts, logistics, process, stakeholders, and response times are just a few of the things to consider and outline before developing a process for handling social media feedback. Based on our experience in the past and the events of April 25, here are some questions you should consider and ask:
- Are you listening constantly and able to act immediately?
- Do you have contacts for every standard issue? I.e. Is there a person you can reach immediately in every department that may be required to assist you with resolution?
- Do you keep key contact information in your line of vision and reach?
- Have you considered every possible one-off emergency that could come your way?
- If every necessary contact in your process disappeared, do you have a back-up plan?
- Do you have a way to communicate to teams in your health care facilities (if decentralized) to keep them in-the-loop?
- Do you have a method to reach other health care facilities in the region if you are unable to help?
- Could you remove spatial barriers to appropriate teams? Are your teams strategically located to aid in social media efficiency?
- Is there a feedback loop in place to allow you to proactively stay informed once a hand-off has been made?
Social Media Process Qualities
Every brand and every brand’s social media manager(s) deals with negative feedback. No company, product, or service is perfect, so none are immune from this. And as discussed above, in health care, the services we provide can oftentimes be life altering ones. Whether or not we’re aware of it, health care social media managers are often leaders of support groups and patient advocacy. As such, providing patients, families and community members with options for effective help and resolution via social media is key.
There are four key qualities consistent amongst every successful health care social media feedback strategy, including ours at Emory Healthcare:
Feedback can come at any time. It is important that the person(s) managing health care social media presence have a constant finger on the pulse of their stream. Personally, when not in-office, I use my mobile phone to remain constantly in tune with and updated on the feedback our Emory Healthcare social media accounts receive. Without a constant listener, there can not exist the constant ability to act. And when there is a crisis or complaint, the response should be immediate.
At Emory Healthcare, when we receive negative feedback, if we don’t have an immediate solution or next step for an individual, we contact them to let them know we’re working on it. If you don’t respond immediately, you miss an opportunity to serve and demonstrate your commitment to your community. On April 25, a lack of urgency would have almost certainly resulted in an immediate loss of life.
Empathy & Authenticity
Every dialogue and situation is unique. Empathy, or at least the ability to acknowledge we don’t know each person’s unique story is so important from a health care social media standpoint. When the situation allows, we must take the time to educate ourselves on the person reaching out, and learn as much as we can about their circumstances. What makes them tick, what have they gone through recently, have they reached out before? When it doesn’t, we must be aware that unique or unexpected circumstances may exist and avoid jumping to conclusions.
When Matthew Browning reached out to us on April 25, there wasn’t time for extensive research. Because I monitor our Twitter and Facebook presence as well as the general health care social media space as close to 24/7 as a human can, I knew of Matthew and his role in the space. I did not know the details of this situation. In fact, when he reached out about who we later learned was his wife’s grandmother, we didn’t know if he was helping his own family member or the grandmother of a friend, but it didn’t matter. What did matter, was the fact that he and his loved ones were in desperate need of help.
The impact of empathy and authenticity on your strategy and process should be pervasive. Empathy and authenticity should exist from start to finish, because if in fact an authentic dialogue, focus on quality of care, and true concern for humanity exist, these qualities are innate parts of your process. Every touch point, whether via social media, in a health care facility, over the phone, or otherwise, should reflect this. If the people involved in your process cannot buy in to this, I suggest you find new people.
Assuming you have the right processes and people in place, EMPOWER THEM! Without being empowered to help people and do the right thing via social media, I and the Emory Healthcare team would have been unable to execute the processes and tactics outlined for above. The more rungs of the hierarchical ladder the person on the front lines much climb, the slower your response and the less effective it will be.
The Opportunity Cost of Fear
Operating in the health care social media space requires the right kind of process, being employed by the right kind of people, with the right kind of attitude, not to mention a lot of effort. So what justifies these things? The risks of not participating in social media far exceed those encountered via participation. From solely a reputation management perspective, health care organizations must consider that at least 59% of internet users use social media to “vent” about a customer-care experience1.
Consider a person taking a flight out of state and receiving the run around from an airline after delays and being rerouted. If this person uses social media technologies such as Twitter, chances are, their following is going to hear about the experience. Flight hassles, however, don’t usually have a lasting impact on one’s life.
Those in health care must always be cognizant of the fact that the work we do has direct and potentially lasting implications for a person’s being. Going through airline security is not as frightening as going under anesthesia before an operation. Being hassled with flight rerouting is trivial when compared to trying to juggle resources to get your loved one seen for emergency surgery. Let’s face it– health care can be scary. It’s our job to remove those fears with action. As humans, we’re much more likely to tell others about a negative experience than a positive one. Whether or not you’re listening, it’s being said, and to a lot more people than you think.
Health Care Social Media – What We Know Now
As much as we’d like to think that formal processes create solutions for every one-off scenario, they don’t. When a person’s life is on the line there isn’t time for following a flowchart or researching his/her history.
When a crisis does arise, it is mission-critical that outlined processes are well understood and can be executed seamlessly, because when in an emergency, as Matthew told us, “You can’t think. You gotta just move.” And he’s right. When a crisis presents itself, we take our training, knowledge, and contacts, and couple those with common sense and urgency, and move. No barriers. No flowcharts. No waiting. What’s most important is acting quickly and effectively in a chaotic time of need; if that means cutting out steps, that’s what has to happen.
However, from our experience on April 25, we have determined that a sub-set of our processes and list of additional phone numbers must be created for such urgent situations. As an example, when Matthew mentioned in his tweet that his grandmother needed a emergency airlift, we did not have an immediate phone number to reference for such a request.
Thankfully, the way we are structured puts us in the same organizational department and physical area as our call center staffed by Registered Nurses. When his tweet was sent, it was a literal 30 second walk down the hall to get contact information and confirm that in order to be airlifted, the transfer service phone number must be called first. (This is why when we contacted Matthew, he was given a phone number for this service rather than directly to our airlift service). This situation proved that careful consideration to things such as departmental organization and spatial closeness can save precious and potentially life saving minutes in an emergency.
We also know with certainty that without Twitter on April 25, 2011, a family would have felt more hopeless and helpless than they already did. They would have had one less avenue through which to gain answers and options. They would have been forced to use alternate streams to get these answers; streams from which getting an answer could have taken much longer than Twitter did. All risks that I personally, and I believe Matthew Browning will agree, we can’t be willing to take. When it comes to saving lives, the motto has to be “by whatever means necessary.”
Health Care Social Media – What We Still Don’t Know
What does all of this mean for health care and social media? This story could mean that Twitter becomes a means to a life-saving end, and it could not. I and the rest of us at Emory Healthcare are not going to pretend to be the authority on the industry. Despite the success of the process, qualities, and methods we use here at Emory Healthcare, when evaluating our interaction with Matthew Browning on April 25 in hindsight, there exists much that can be improved and much that we still don’t know. Below are several unanswered questions that we hope generate a dialogue that lead to our community sculpting its own answers, rules, and ideas for what the future of health care and social media will look like.
Does Network Size & Influence Matter?
It turns, as was touched on in Part I of this case study, that Matthew Browning is well-connected in the health care and technology spaces. So much so in fact, that even prior to the events of April 25, 2011, we were already following him on Twitter from our Emory Healthcare account. His level of influence is an important consideration when evaluating this case. Matthew’s necessity for a regionally based facility for his wife’s grandmother is also an important one. Matthew resides in the Northeast, and his connections are by and large from the same area. As Matthew told me on Tuesday “I was out of my turf, but I have a great network.”
Questions we must consider regarding Matthew’s background include:
- Did his level of influence and large network of industry peers impact his ability to get help via Twitter?
- If so, how would those without such a network achieve similar volumes of quality and actionable assistance in the time of a health care crisis?
- To what extent did Twitter allow Matthew to dissolve geographic and time consuming barriers to help?
- What role did Matthew’s intrinsic knowledge gained from his background in health care play in his ability to break barriers & get help?
What does it All Mean?
As mentioned above, we are not going to pretend to be the industry authority on the future of how social media will be used in health care. While on a personal level, this story means more to me than any number of words can express, from an industry perspective, the final outcome may prove to have nothing to do with social media.
Our interaction with Matthew Browning has many potential future implications for health care’s use or lack of use of social media. Maybe it means we need to open doors that make immediate assistance a more reasonable thing to achieve. Maybe it means a discussion around privacy as it relates to saving lives emerges. Maybe it means there needs to be a long and hard look taken at improving access to regional emergency care. Maybe it means the 9-1-1 system needs an upgrade. To be honest, we don’t know what it means.
The Inherent What-Ifs
The overwhelming majority of people working in health care social media will tell you themselves, the space is filled with a lot of “what ifs”:
- What if someone exposes their personal information to us in a public arena such as Twitter?
- What if we aren’t careful and diligent in our response, could we further compromise that person’s privacy?
- What if we can’t help?
- What if we don’t respond? But most importantly, what if we do?
Author: Morgan Griffith, Web Communications & Social Media Specialist, Emory Healthcare