Radiology Practices Reap Social Media Dividends
For more than a decade, patients have been assuming greater control over their healthcare, facilitated almost exclusively by the internet. Clinicians and administrators alike are well-aware of the benefits and dangers of this trend—informed patients can make better decisions regarding their health; misinformed patients, in addition to making poor decisions, may mimic sophomoric med students with compulsive and inaccurate self-diagnoses.

Instead of standing by and watching the virtual affair unfold, radiology practices are now reasserting their own roles in healthcare, as sources of accurate and reliable information for patients and referring physicians. Outside of the clinic, the main venue for this stepped-up dialogue is social media. Consider:

In 2009, after Inland Imaging in Spokane, Wash., launched a Facebook page and website targeting under-screened women, mammography exams increased 9 percent.

Each Facebook post touting cardiovascular and breast screening nabs up to 600 impressions for St. Luke’s Health System in Sioux City, Iowa.

Perhaps better than any other physicians along the continuum of care, radiologists understand the importance of establishing and maintaining relationships—radiology’s lifeblood is referrals from other physicians. Whereas radiology practices have traditionally depended upon direct relationships with referring physicians, medical marketers are employing sites like Facebook and Twitter to induce referral requests or walk-ins from patients. A 2009 Manhattan Research survey found that 35 percent of adults in the U.S. rely on social media as a source for medical information. Referring docs maintain cardinal influence over referrals, but radiology practices can affect more patient flow by entrenching relationships with prior as well as potential patients. Aside from providing quality healthcare, one of the most effective ways to influence patients’ choices of caregivers may be social media.

Relationship-building enters the social media era

“The key to building relationships in medicine is always going to be establishing yourself as a reliable and loyal resource to patients and referring physicians,” says Kim Longeteig, founder and principal of Ali’i Marketing and Design in Waikoloa, Hawaii, which caters to radiology practices. In the last few years, social media has started to supplant traditional radiology marketing services.

Hundreds of thousands of people officially “like”—follow or periodically visit—the pages of hospitals and radiology practices on Facebook. Inland logs 6,300 followers on its two Facebook pages.

Inland has taken a rigidly strategic approach to Facebook, making sure to post consistently and deliberately, which means an end-of-the-week public relations meeting to set the next week’s social media agenda, according to Marketing Director Jason Miller. The practice spends $6,000 per year on social media promotions and advertisements, plus the salary of a full-time digital media specialist.

The costs pale in comparison to the benefits, which include 25 percent more traffic to the practice’s website (measured by Google Analytics); TV and radio coverage; partnerships with local businesses and university athletics; and increased examination volume. This last effect deserves real scrutiny: How can a practice attribute greater patient volume—and improved patient outcomes—to internet marketing?

Return on investment (ROI) haunts the intangible purview of public relations. “How do you measure that sort of thing? By Facebook friends? Impressions [page views, for which Inland averages about 3,000 per post]? Patient comments? I just don’t think anyone has gotten their arms around that one yet,” considers Cheri Bustos, vice president of public relations and communications for Iowa Health System (IHS), based in Des Moines.

“While of course we cannot conclude that 100 percent of our increase in screening was due to social media, it is pretty close when it comes to mammography, which is self-referring,” argues Miller. Inland conducted extensive research on Spokane women aged 40 to 65, discovering large pockets of women unscreened for breast cancer—most of them blaming their truancy on a lack of time and money. With patient care and ROI on the minds of the group’s marketing staff, administration and radiologists, Inland launched an aggressive web-based campaign targeting more than 3,000 Facebook members to fuel participation in screening. The comprehensive promotion targeted populations not routinely screened, offered free mammograms for underserved women and leveraged increasingly popular “mammography parties,” which were sponsored by local TV stations, businesses, sports franchises and charities. In the economically sparse 2009, Inland saw a 9 percent jump in mammography and a 14 percent growth in cancers found—owing to the jump in under-screened women.

An integrated approach—eventually

Facebook is the x-ray of social media: the site unequivocally dominates the field; but no marketing strategy “is fully functional unless you utilize all the platforms,” emphasizes Leslie Heying, public relations coordinator for St. Luke’s Health System in Sioux City, Iowa. Heying and two colleagues share responsibilities for updating social media at St. Luke’s, with each of the three responsible for devoting 15 minutes to an hour or more each day posting information to Facebook, Twitter, LinkedIn and YouTube.

St. Luke’s captures its largest audience by advertising the hospital’s events—including cardiovascular and breast screenings—on Facebook, grabbing up to 600 impressions for each post. And while Facebook wields the broadest efficacy for building relationships with patients, by no means should it limit a practice’s social media outreach.

Careful to tailor their messages to each site’s divergent audiences, Heying and colleagues have found that Twitter followers are more commonly businesses, other healthcare providers and the media. Another IHS St. Luke’s hospital, this one in Cedar Rapids, used Twitter’s 140-character limit to transmit a play-by-play of a robotically performed hysterectomy and uterine prolapse surgery in a consenting 70-year-old woman. Nearly 700 Tweeters followed the operation, which was picked up by the Associated Press, national and international media.

And while the YouTube channel at St. Luke’s in Sioux City remains a bit lighter, all of these outlets connect hospitals to patients, albeit in sensationalized manners at times. But, Miller notes, “Remember, social media is meant to be social and engaging. If you seek too much to inform and educate, you will inevitably bore your audience.”

One of the democratic advantages of social media is the low-cost. The main avenues—Facebook, LinkedIn, Twitter and YouTube—are all free to use. However, the main resource constraint is drained time, which is a danger not to be overlooked. “My advice to any group is to start with one platform, probably Facebook,” offers Longeteig. “It seems so easy to just start Facebook, Twitter, LinkedIn and a blog, but if you fall behind you can end up doing more harm than good, by looking unresponsive. First, clearly define your strategies and goals, and then expand as you move along.”

A new recruiting avenue

“If we weren’t on all the social media sites, we would be missing a large part of the population,” says Mandie Norby, marketing coordinator for St. Luke’s in Sioux City. As the webwork of relationships with patients, local partners and the media becomes ever more ensconced, practices are beginning to gear at least two media venues, LinkedIn and blogs, to professionals.

Inland unofficially requires staff members to post their credentials on LinkedIn as a means of showcasing the group’s talent, Miller explains. St. Luke’s and IHS use LinkedIn, Twitter and Facebook to post higher-level job opportunities, hoping that their own staff’s profiles will not only impress potential patients but also help recruit expert faculty.

Blogs also stand as a medium for posting public interest stories and reaching audiences that might not feel compelled to follow a practice’s Facebook feeds or LinkedIn profiles. hosts a blog by IHS’ CEO Bill Leaver, where he shares business and health insights with Iowa’s small business community while also forging relationships for IHS. Inland has used its blog to reach—and uniquely involve—physicians. In one such case, the group’s vascular director kept a travel log of his trip to Japan, where he offered clinical instruction on interventional procedures. More recently, Inland publicized its donation of 147 free on-site x-rays at the world’s largest three-on-three basketball tournament, held yearly in Spokane.

The fine print

Like all social media users, healthcare need to live by the rules. Privacy and the appropriateness of content in social media are major concerns for many administrators, and with frighteningly targeted advertising costing just $1.25 per click, practices understandably wonder about their own information as well. Charlotte Radiology in Charlotte, N.C., absolved responsibility by posting the Health Insurance Portability and Accountability Act (HIPAA) privacy rule on its Facebook page.

Still, posting the HIPAA rule might not be enough when it comes to physician-patient relationships on Facebook and other sites. Several medical organizations, including the American College of Physicians, are in the process of developing social media guidelines in light of growing patient requests to “friend” or “follow” their doctors, according to Katherine Chretien, MD, associate professor of medicine at George Washington University.

In reality, few individuals have the motives to vulgarize a hospital. However, patients can and do voice their complaints on these forums. “Practices often ask me ‘What if someone places a negative post?’” Longeteig shares. “My response is: ‘So what if they do?’ If a patient says he or she had a bad experience at your institution, to me, that’s an opportunity to correct it and demonstrate your strong customer service to others.” Inland and St. Luke’s also have come to value the opprobrium as customer service opportunities. All three have found that the best solution is to let the online community know that the group is rectifying the problem, while contacting the patient directly and taking the matter off of the public domain. In addition, most practices have no tolerance policies for offensive material. Social media policies are necessary and thus far effective at maintaining patient privacy and institutional professionalism.

Putting a face to those profiles

Longeteig sums up social media’s outreach mechanism as helping to “provide business and market intelligence; enabling you to learn and tap into patients’ interests and preferences; building a community; and sharing information efficiently.” But how can these strikingly commercial strategies be reconciled with the physician ethos of “the patient comes first,” and should radiology and patient outcomes even be impregnated by these tactics at all?

Bustos, who is in charge of IHS’ corporate PR and works with marketing and communications directors to help coordinate media relations for the system’s 25 hospitals and 140 clinics, calculates her strategies in the following way: “[The industry as a whole] needs to be more strategic about how we are using social media. We have been real trial and error, hit and miss, up until now.” As decoupled as marketing and health may seem, Bustos’ modesty belies the improved patient outcomes that IHS has achieved: social media has brought the system increased participation in health screenings, mammography parties and health classes (Facebook provides RSVP information to track attendance). “Look, we’re in the business of helping people, and that needs to be our purpose going forward—how can we use social media to improve people’s health?”