EHR handcuffs: Let Doctors be Doctors.

EHR has been a topic of interest for me for a long time, and was one of the topics I chose to research in depth during my MBA, five years ago. Five years ago we were half a decade away from the 2015 American EHR, EMR, HealthIT, let doctors be doctorsRecovery and Reinvestment Act deadline that would penalize providers for not having adopted an EHR.  Five years ago, there was potential to develop a transformational EHR that would truly connect physicians, patients and healthcare stakeholders. Five years later and it is safe to say the initial roll out failed. Physicians overwhelmingly are still stuck with awful EHR platforms that do anything but allow physicians to practice real medicine, by creating electronic silos and adding little to no value.

On a sales call in Maryland in 2010, I visited one of my customers who was 72 years old with no intention of retiring any time soon. When I asked him why he continues to practice medicine he stated, “I’m not in medicine for the money. I do it because I love to see my patients. My patients need me. Medicine is always changing and I’m always learning something new.” Therein lies a major disconnect between EHR implementation/mandates and the real world.  When EHRs serve the purpose of acting as “glorified billing platforms” and require 20 clicks to get a simple medicine, the real goal of EHR and so called meaningful use dissolves into meaningless use. (You see what I did there?)

“I’m not in medicine for the money. I do it because I love to see my patients. My patients need me. Medicine is always changing and I’m always learning something new.”

I believe technology used in the right way will change health care for the better.  There is proof of this concept staring us in the face: social media connecting patients and physicians all over the world, wearables that engage patients to improve their own health, the list goes on.  So why, when it comes to technology that documents the human part of health care, is it so hard to get that part right?  Why are EHRs the most inhuman part of health care today? Why is it that health care is stuck in the 90’s: faxing millions of papers per day and requiring antiquated EHRs?  It makes no sense!

Thankfully, there’s a real movement at foot to make this change.  This brings me to one of the most disruptively creative forces in health care today- ZDoggMD.  ZdoggMD (otherwise known as Zubin Damania, M.D.) is leading this change by using satire to highlight what pains healthcare providers most. Through humor, he shows us how truly broken our healthcare system has become and has built a following of people ready to help change it.  The latest video “EHR State of Mind” had me laughing hysterically because everything in it is (unfortunately) SO TRUE.  ZDogg is helping to head up a movement in partnership with AthenaHealth called, “Let Doctors be Doctors,” which calls for a new EHR that connects stakeholders and actually allows doctors to, well, be doctors.

The lyrics, set to the tune of Jay-Z’s “Empire State of Mind,” are smart and funny.  It’s sure to hit home with anyone working in health care these days. To learn more and to voice your experience with EHR head over to Let Doctors be Doctors and follow the hashtag #letdoctorsbedoctors.  Without improvements to EHR it’s not just doctors that suffer.  It’s the whole healthcare team that cares for patients and patients, as well.

“Tech should bind us, not blind us to the reason why we care, patient’s face reminds us.”

“Innovation all around but it ain’t in healthcare. Internet and apps for you, but we get ancient software.”


Dying for a cure this Pinktober: Metastatic Breast Cancer Awareness

Pink parties. Pink Ribbons.  Pink celebrations. Pink boas.  Pink bagels.  You name it, it’s pink in October.  Many people, breast cancer patients and others, find empowerment and emotional comfort in “pink.” Many feel as if they have done good by participating or buying a “pink” good. As I’ve mentioned before in my post, Missed Opportunities: Celebrities are not doctors,  I think it is important to respect and acknowledge that everyone finds empowerment through different avenues. Pink is not evil, although it has been grossly contorted by commercial organizations. Today I want to highlight a group of people who do not find comfort in pink: women and men living with metastatic breast cancer. In fact, these women and men feel marginalized, left out of the breast cancer conversation and hurt by pink.  These are the stories you don’t hear during breast cancer awareness month.  There are no pink boas and glitter.  There are heart wrenching stories and people working together tirelessly for a real change for breast cancer research. If you take a chance to really get to know the stories of metastatic breast cancer, (stage IV breast cancer), your eyes will be opened. I know mine were. The first time I watched this video below, I was shocked.  It took my breath away.

I am concerned and discouraged by “breast cancer awareness” campaigns like “No Bra Day,” that serve no purpose other than to sexualize breast cancer, to focus only on the breast and not the LIVES that breast cancer impacts, and to diminish the importance of today, October 13th, Metastatic Breast Cancer Awareness Day.  Here’s the hallmark media piece for No Bra Day:


This campaign and it’s marketing collateral show a complete lack of understanding and empathy for a patient’s journey through breast cancer and a mastectomy.  It’s gross.

Metastatic breast cancer is breast cancer that has spread beyond the breast to other parts of the body.  Often this includes the brain, bones and lung.  Metastatic disease has no cure. It’s painful.  It steals women and men from their families.  It cares nothing of age, race or gender. It has no cure. Patients will live the remainder of their lives undergoing treatment.  There’s nothing sexy, pretty or celebratory for patients with metastatic disease.  Go ahead and tell a metastatic breast cancer patient, or any cancer patient, they “got the good cancer.”  See what kind of response you get.

The reality is that over 100 patients die, every day, in the United States from metastatic breast cancer.  The reality is that roughly 30% of breast cancer patients, regardless of stage at diagnosis, will develop metastatic disease.  The reality is that only 2% of breast cancer research dollars go to fund the deadliest type of breast cancer when one third of breast cancer patients will die from metastatic breast cancer.

The metastatic breast cancer community deserves better.  They deserve our support.  They deserve better and more research funding. They deserve to be at the forefront of the conversation, because metastatic breast cancer is what kills women and men with breast cancer. 30% is not a small proportion.  30% of all breast cancer patients are estimated to develop metastatic disease.  (Why do I say estimated?  You may be surprised to know that the SEER database does not track when a patient’s disease progresses from early stage to metastatic. I found this interesting blog post with a response from NCI on why it is not tracked. The gist: lack of financial resources and complexity of tracking.)


Rather than focus on what’s negative, however, I want to highlight some of the good.  Today, is hosting a “die-in” in Washington, D.C. to highlight the tragic state of breast cancer research for metastatic breast cancer.  All over the country, people are taking a stand, and highlighting the real, ugly truth about metastatic breast cancer: it kills. To follow the die-in and learn more from patients, families, healthcare providers and caregivers affected by metastatic breast cancer, please follow the hashtag #pinktoblack.  If you’re not motivated to spur change after reading through the tweets, I’ll be surprised.

So let’s stop with the campaigns like No Bra Day and Save the tatas.  Women and men diagnosed with breast cancer are people with lives.  People with families, people with aspirations, people who are “dying for a cure.” Let’s make a difference.  Support organizations like METAvivor and MetUp that are starting to make the real uncomfortable conversation heard.

#pinktoblack metavivor breast cancer awareness #bcam

Want to learn more?  Here are some great metastatic breast cancer resources:

  1. METAVivor: “METAvivor is dedicated to the specific fight of women and men living with stage 4 metastatic breast cancer. At the time of METAvivor’s founding, no organization was dedicated to funding research for the disease and no patient groups were speaking out about the dearth of stage 4 cancer research.  While more and more people have taken up the cry for more stage IV research, METAvivor remains the sole US organization dedicated to awarding annual stage IV breast cancer research.”
  2. MetUp: “METUP is a diverse, non-partisan group committed to direct action for a viable cure for breast cancer. We protest and demonstrate; we meet with government and health officials and researchers; we support research into metastatic disease; and we speak out against the sexualizing of breast cancer. We are convinced that the deaths of women and men from metastatic breast cancer are a paramount issue, and we pledge ourselves to oppose all who deny the reality of the 522,000 people who will die from metastatic breast cancer globally every year while waiting for a cure to be found.”
  3. Metatstic Breast Cancer Network: “MBCN seeks to: EDUCATE patients about metastatic breast cancer treatments and how to cope with the disease; Educate the public about the differences between early and advanced stage disease. EMPOWER patients to use their story and voice to bring attention to the needs of metastatic breast cancer patients and to use their knowledge to participate more fully with their healthcare provider. ADVOCATE for focused research to find more targeted therapies to lengthen the lives of patients and make metastatic breast cancer truly a chronic disease like diabetes or HIV/AIDS.
  4. National Comprehensive Cancer Network Stage IV Breast Cancer Patient Guide: NCCN is a not for profit alliance of 25 of the world’s leading cancer centers, and provides what are considered the gold standard for cancer treatment.  This e-book is written specifically for patients diagnosed with metastatic breast cancer in patient friendly terms.

Social Media Management Tools: because time is precious.

Managing multiple social media channels, keeping content up to date and not spending ALL your time furiously trying to keep up can be done.  I assure you of this.  Today there are many great social media management tools available that can help with curating content, sparking new ideas, managing communities and keeping you sane.

Recently, I connected with Chris Makara, an interactive marketing and digital strategist. Chris asked me to participate in a publication regarding social media management.  The post went live yesterday and is full of goodies for anyone interested in making the most of their social media accounts and streamlining their efforts.

Chris asked us all one question:

“If you could use only 3 tools for social media management, which 3 tools would you use?”

To see what I chose, head on over to Chris’ post over at “100+ experts reveal their favorite social media management tools” and scroll down to my contribution!  In addition to the great post, you can also download a free PDF of all the tools recommended by our panel. Many thanks to Chris for reaching out and including my thoughts on this social media management panel publication!

National Cancer Institute SEER Cancer Statistics Review: 2015 Updates

The NCI published updated SEER Cancer Statistics data today, April 23, 2015. The data is now current through 2012. SEER stands for Surveillance, Epidemiology, and End Results Program.  The SEER cancer statistics review is a report of, “the most recent cancer incidence, mortality, survival, prevalence, and lifetime risk statistics.”

This data is helpful in tracking population trends in cancer and for learning more about how our country is doing at diagnosing and managing cancer.  SEER data is very interesting for those in oncology sales and marketing, as this data can be used to target messaging, identify market potential and identify areas where clinical utility of a product is succeeding or failing. The new SEER data suggests that 1,658,370 new cancer diagnoses will occur in the U.S. in 2015, with 66.5% of all cancer patients surviving 5 years or more. These statistics are inclusive of all cancer sites that SEER registries track.

Common Types of Cancer Estimated New
Cases 2015
Deaths 2015
1. Breast Cancer (Female) 231,840 40,290
2. Lung and Bronchus Cancer 221,200 158,040
3. Prostate Cancer 220,800 27,540
4. Colon and Rectum Cancer 132,700 49,700
5. Bladder Cancer 74,000 16,000
6. Melanoma of the Skin 73,870 9,940
7. Non-Hodgkin Lymphoma 71,850 19,790
8. Thyroid Cancer 62,450 1,950
9. Kidney and Renal Pelvis Cancer 61,560 14,080
10. Endometrial Cancer 54,870 10,170
 All Cancer Sites 1,658,370 589,430

SEER Cancer Statistics Factsheets: All Cancer Sites. National Cancer Institute. Bethesda, MD,

An overall glance at the SEER statistics shows the following :

  1. Based on 2010-2012 data, roughly 39.6 percent of men and women in the U.S. will be diagnosed with cancer at some point in their lifetime.
  2. The number of new cases for all cancer sites tracked by SEER data has been falling every year for the last 10 years at a rate of 0.9%, however, death rates have remained stable.
  3. The mean age of diagnosis for all cancer sites is 65, with most of the population diagnosed between ages 65-74.

NCI SEER data update 2015
SEER data is collected via population health registries located throughout the country and aggregates the following data:

  • Patient Demographics
  • Primary Tumor Site
  • Tumor Morphology
  • Extent of Disease
  • First Course of Treatment
  • Active follow up

A list of the population health SEER registries can be found here.

This data is divided into cancer site specific groupings and further detail is provided:

  • Cancer Incidence
  • Mortality Rate
  • Survival
  • Prevalence
  • Sex, age, ethnicity
  • Staging
  • Geographic area

SEER data can be examined from many different perspectives using free interactive tools available on the NCI website, including age of diagnosis, ethnicity, geographical location (down to the county!), physical location on the body, mortality rate, etc.  The Fact Sheets provided by NCI are really interesting and give a great overview, with nice visual. NCI SEER data can be followed on Twitter using @NCICancerStats. Updates are published annually and the data is available to the public at all times.



Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2012, National Cancer Institute. Bethesda, MD,, based on November 2014 SEER data submission, posted to the SEER web site, April 2015.


Online Content Strategies and Paid Promotions in Healthcare Social Media

Welcome back to my three part series on creating a best in class healthcare social media strategy.  Part one discussed the building blocks of a social media strategy, and important questions that all brand managers and communications professionals should ask before sending that first post.  Part two focuses on content strategies for Facebook and Twitter and some how to’s on leveraging paid promotions in Facebook and Twitter.

As a review, your brand voice should be consistent across all platforms.  This holds true whether you have 140 characters to work with or unlimited characters at your disposal.  This is not to say that a brand will message everything the same way on each platform. In fact, I would encourage brands to message differently on Facebook vs. Twitter.

Personalization and emotional connection to healthcare brands is more important than ever. Broadcast, push it out, jam it down your throat marketing is no longer a successful strategy. Healthcare social media represents the perfect platform for sharing the real stories behind the people and place where patients seek care.  Choosing online content carefully and purposefully must be a key strategy for any healthcare social media team.

Patients of today are educated and making more informed, active decisions about their health. That means healthcare organizations must recognize and embrace the patient perspective. Patients want to know more about their healthcare organizations than ever, and that doesn’t mean how many beds a hospital has and how many awards a physician has won.

Great healthcare brands are not great by accident on social media.

Most patients will avoid thinking about health related issues until they have to.  No one sits around fantasizing about the joys of long term care or choosing a cancer center because it is an enjoyable experience.  As such, the times when patients are interacting with a healthcare brand are often emotionally charged, stressful periods during their life. However, great healthcare brands keep their patients engaged even after the period of immediate need is completed.  Great healthcare brands are not great by accident on social media.

Consider the following facts related to healthcare and the Internet from Pew Research Center:

  1. 59% of adults in the U.S. have looked online for health information in the last year
  2. 35% of adults in the U.S. have used the Internet to confirm a diagnosis or figure out what medical condition they have
  3. 53% discussed what they found on the Internet with their healthcare provider
  4. 41% of “online diagnosers” had their diagnosis confirmed by their healthcare provider

Understanding your target market is key to becoming a successful online healthcare brand.  Before posting content on social, it is critical to perform market research to understand how your brand is perceived in the market, to discover areas of strength and to identify areas of weakness.  Conducting this type of research on your competitors is also a good idea, as well. Hopefully, your marketing and public relations team completes this type of research at least yearly. As a social team, you should be looking at it all, very carefully, before starting a social campaign. For a really great, in depth look at the detailed, purposeful work that must go into creating online patient communities, head on over to Dan Dunlop’s blog “The Healthcare Marketer,” and read as much as you can. Also watch this great video presentation, “Launching Online Patient Communities: look before you leap,” by Dan and Dan Hinman of Hive Strategies, which is the best guide to building online patient communities that I have found to date.

Online Content Strategies for Facebook and Twitter, and leveraging paid promotions

Online content strategy on social is a four part package, in my opinion.

  1. Creating/curating/qualifying content
  2. Determining time to respond to audience for positive, negative and neutral comments
  3. Buying paid promotions
  4. Evaluating success of each piece of content and promotion

Quality online content is key to a successful healthcare social media strategy.  In healthcare, many brands find the greatest success using patient stories, provider stories and telling the real story of the people behind the care.

Remember, there is no magic bullet for success on social media, but there are best practices that are worth implementing, and worst practices that are worth avoiding.

PUGTATO’s nine recommendations for Facebook content strategy:

  1. No more than two posts per day.
  2. Keep it positive.
  3. Provide a link or a picture for readers to click on.
  4. Always include a call to action, e.g., read this, take a look, please share, go here, tell us what you think etc.
  5. Use pictures and videos. Research has demonstrated that posts with pictures and videos have dramatically more user engagement than non-picture posts.
  6. Decide on set schedule for posting.
  7. Monitor Daily.
  8. Decide on agreed upon response time.
  9. Get friendly with automated software

None of these are set in stone and are general recommendations that have worked really well for us at Breast Care for Washington.  Remember, there is no magic bullet for success on social media, but there are best practices that are worth implementing, and worst practices that are worth avoiding. As you engage with your audience you will learn what they respond to, and that will help you learn how to develop meaningful content.

Facebook remains the most popular social media platform available, and has increasing numbers of seniors joining. As of December 2014, Facebook reports 890 million daily active users, 745 million mobile daily active users and 1.39 billion monthly active users. 70% of Facebook users engage daily, and 45% of users engage more than once a day.

Pew Research Center reports that 52% of online adults use multiple social media sites, but that Facebook remains users go-to platform if they only use one. Facebook is non-negotiable.  Any healthcare brand seeking to appear credible and approachable must be on Facebook.

PUGTATO’s six recommendations for Twitter:

  1. Post at least once a day.
  2. Favorite, Retweet and respond to followers and users daily.
  3. Schedule at least one tweet a day with a link to an industry article unrelated to your organization/brand
  4. Check context of hashtags before use! You don’t want to end up in the company of DiGiorno Pizza and other corporate hashtag disasters, believe me.
  5. Use no more than three hashtags per tweet.
  6. Get friendly with automation software.

Twitter is different from Facebook.  You are less likely to hit as many people in your audience with a single tweet as you are with a single Facebook post.  As such, tweeting 10 times a day will be better received by your audience than posting to Facebook 10 times a day.

When tweeting multiple times a day be sure to space tweets out- rapid fire tweeting within a five minute time period will 1) annoy your followers, 2) defeat the purpose of using multiple tweets, 3) probably get you unfollowed or muted.  This of course does not hold true if you are participating in something like a TwitterStorm, which was used this past February to educate the public about measles, using the hashtag #MeaslesTruth.  The idea was to “dump 10 minutes of the truth.” The #MeaslesTruth Twitterstorm resulted in  5.7 million impressions in 10 minutes. (See the analytics here.) Here’s a great article from Symplur that describes the strategy and idea behind using a #MeaslesTruth TwitterStorm to educate about important health issues. The full #MeaslesTruth TwitterStorm transcript is available here.

Response time to audience:

Responding to your audience is very important to building engagement on social media.  Hopefully, this is not a foreign concept. What may be a new concept, however, is the idea of carefully choosing response times. Setting guidelines that are realistic for your organization will help to build structure into your social media monitoring and evaluation.

For example, let’s pretend a patient comments on your picture with a question and you respond within 5 minutes.  This happens a few more times and you respond almost immediately.  By doing so, you are setting a precedent that consumers can expect a nearly instantaneous response from your brand.  While this may be realistic on a certain day, most likely, an instant response is not sustainable long term.

This is why I recommend sitting with your social team and determining:

  1. What is a realistic timeframe for responding to your audience? Will the goal be the same for positive, negate and neutral comments/questions? How will response times differ on each platform?
  2. What type of comments will not be responded to?  What type of comments will be deleted- if any?
  3. Who will respond? Who needs to approve responses to patients?

In my opinion, waiting 24 hours to respond is unacceptable. Having an engaged social team means responding to your audience in a timely manner.  This means that your social accounts need to be monitored throughout the work day, and a brand should always attempt to respond same day. Additionally, always attempt to take negative responses off-line or into a private message if possible. Getting friendly with social automation tools like HootSuite, HubSpot,, and can all help with content curation and community monitoring.

In a healthcare setting, sometimes responses will need to be approved by your PR department or executive management due to HIPAA or other issues. There may be set messaging that is required, and the conversation may be better held offline.  Comments that violate your community’s standards should be removed, e.g., hateful comments, bullying, etc.  Stating your community’s standards clearly will help to define what is and what is not an approved topic for your page.

Timely monitoring of social accounts will allow your social media team to aggregate comments and to share the trends they find with marketing and PR and also the managers in relevant departments.  If someone is doing a great job on the oncology floor and multiple patients have commented about it- share it with the department and that employee!  Same goes for repeatedly negative comments.  Lots can be learned from patients in this setting.

PUGTATO’s Recommended Daily Social Media Check List

Daily Social Media Check list

  1. Check for tweets, comments, messages and mentions from followers. Refer questions to appropriate person before responding.
  2. Like, favorite, comment and retweet where appropriate.
  3. Check for friend requests and new followers. Follow back where appropriate.
  4. Double check tweets/posts from yesterday to ensure they are still relevant with today, e.g., have you posted accidentally in relation to an unexpected crisis, has your messaging somehow been linked to a negative event?
  5. Double check all posts from yesterday have working links to the intended content.
  6. Double check all posts from yesterday for typos.
  7. Review social media requests from different departments.
  8. Check paid promotions to ensure they are on budget and performing.
  9. Check editorial calendar, check with team to confirm events and industry news that may be relevant to audience.
  10. Schedule tomorrow’s posts/tweets. Check links, check for typos and check to ensure messaging is inline with decided brand voice.

Paid Promotions on Facebook and Twitter

Paid promotions on Facebook and Twitter are a great way to use marketing budget to target your desired audience.  In fact, paid promotions have become increasingly important for brands on Facebook, as the new algorithms for Facebook news feeds have dramatically increased the need for brands to “pay to play,” so to say.  While engagement will always be a driver of who sees your posts, in order to be placed into a friend or followers newsfeed, brands are now required to purchase that prime real-estate to ensure posts are seen by a larger proportion of a target market.  Keep in mind, the larger proportion is still quite small even with a purchased promotion, (e.g., 20,000 out of 300,000 targeted) but promotions work. Facebook advertising allows for numerous promotion opportunities in terms of ad placement, type of ad and cost.

Before purchasing an ad placement:

  1. Decide on the goal of your advertisement: engagement, page likes, website visits, etc.
  2. Decide on your budget.
  3. Choose target audience.
  4. Build messaging and imagery.
  5. Complete an A/B test on imagery and messaging using a small ad spend to help determine what message/image has the most impact with your audience. You might be surprised!
  6. Review ads weekly to track performance and make tweaks to messaging or imagery. Performance indicators to track include: impressions, click through rate, conversions. If these indicators are decreasing quickly then a change to the ad should be made.
  7. Update Facebook promotions roughly every 1-3 months, Twitter every 1-2 weeks.

Ad choices in Facebook:

  1. Right hand column ad– Desktop only, not visible in mobile app.
  2. Sponsored ads in newsfeed– The larger the budget the better these advertisements will do. Newsfeed placement is prime retail, and larger brands can afford to price out small companies. Think of these ads as you would buying a house- the cost is relative to how much someone is willing to pay for it.
  3. Post boosting– For as little as $5 a Facebook post can be boosted. You can determine a budget and timeframe to “boost” your post, allowing it to be seen by more people and more frequently.

In general, we found at BCW, our mobile advertising social placements did better than desktop view placements. Less than 1% of our views/clicks were from desktop users. Take a look at your analytics to determine which distribution channel makes the most sense for your brand.

Ad choices in Twitter:

  1. Promoted Tweets – Regular tweets that a brand wants to be seen by a larger audiences or to increase engagement. These are shown in users timelines.
  2. Promoted Accounts – User accounts that a user does not follow but may find interesting based on what they tweet and who they are connected with. This type of ad is useful for increasing followers. These advertisements are featured in users Home timeline, search results and who to follow suggestions.
  3. Promoted Trends – Time, context and event sensitive trends. These ads show in the trending tab on Twitter and occasionally in users timeline.

For more info on Twitter advertising go here.

Healthcare consumers want and need social proof from brands. They will look online to learn about your organization or product before going or using. Taking the time to carefully plan and strategize your social media efforts will pay off in the long run by increasing brand awareness and positive brand associations, all while driving revenue growth for your organization.  See you next time for Social Media Crisis Management and the release of my Social Media Content Strategy Template!

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Ovarian cancer makes me angry.

Ovarian cancer makes me angry.  Symptoms are vague, which means it is often diagnosed at a late stage and there are limited therapeutic options available for treatment.  It’s not fair.

Let’s look at the symptoms:

  • Bloating
  • Feeling full quickly
  • Pain or pressure in the abdomen/pelvis
  • Abnormal vaginal bleeding

My guess is you have experienced all of these at some point in your lifetime. No big deal, right? This is one of the reasons ovarian cancer is often called the silent killer.  Additionally, many women are under the misconception that their yearly pap smear screens for ovarian cancer.  I am here today to tell you: it doesn’t.

There are no general population screening guidelines for ovarian cancer. Transvaginal ultrasound and CA-125 blood tests are the two most common ways that doctors screen for ovarian cancer in patients with an elevated risk. Transvaginal ultrasound provides an image of the ovary.  Think of it as a sort of mammogram for the ovary.  It can detect ovarian cancer early. CA-125 is a protein that is elevated in roughly 90% of ovarian cancers but can sometimes be elevated in patients without ovarian cancer.  CA-125 is generally considered more informative once a patient is diagnosed with cancer as elevations over time can indicate recurrent disease or some other change worth investigation by a patient’s oncologist.

Both transvaginal ultrasound and CA-125 blood tests have limited clinical utility, but they are all we have right now. For more on risk factors and screening guidelines, check out this easy to read and understand information guide from a world leader in cancer care, Memorial Sloan Kettering Cancer Center.

One fact that all patients with ovarian cancer should know is that the National Comprehensive Cancer Network’s guidelines clearly state that all patients with epithelial ovarian, primary peritoneal or fallopian tube cancers meet criteria for BRCA testing, regardless of age.

All patients with epithelial ovarian, primary peritoneal or fallopian tube cancers meet criteria for BRCA testing, regardless of age.

The general population carries up to a 1.5% risk of developing ovarian cancer in their lifetime. Women positive for a BRCA mutation carry up to a 44% lifetime risk of ovarian cancer. One in eight patients who have ovarian cancer will test positive for a BRCA mutation and that information can be used to:

  • Follow very specific serial sectioning guidelines for the tumor of a BRCA positive patient,
  • Guide treatment decisions,
  • Build a personalized management plan, and
  • Empower family members, hopefully preventing an ovarian cancer diagnosis in future generations of a patient’s family.

Even in this day of on-demand information, only 25% of all patients with ovarian cancer know their BRCA status and the overwhelming majority of ovarian cancers are diagnosed when distant metastasis are present.

As a healthcare world, we are not doing a great job at identifying and offering testing to this patient population. Hopefully celebrity stories like Angelina Jolie’s will help, but that is not enough. There is so much work to be done to educate and raise awareness about this disease.  Spread the word. Get the facts. Be empowered.


How to create a Healthcare Social Media Strategy: Part 1

Creating a formal social media strategy and policy is important for all organizations.  Healthcare organizations face unique challenges in communicating over social media, but that does not mean social should be ruled out as a communication and marketing strategy.  In fact, healthcare organizations that use social media are seen as more cutting edge and more patient friendly to consumers than those that don’t.

If you are a marketing manager or a communications strategist building a social media strategy for your healthcare organization, this post is for you.  Welcome to my three part series on how to create a best-in-class healthcare social media content strategy.  This series provides real world recommendations and industry best practices for developing a strong healthcare social media strategy that can be implemented immediately.

Recently, I wrote Breast Care for Washington’s Social Media Handbook using best practices and tips I’ve picked up along the way from colleagues, Stanford’s Medicine X,  and the Society for Healthcare Strategy and Market Development. As I worked through the pieces of our strategy and actually put them to paper, I thought others might find this thought process helpful. Part one covers the building blocks of a social media strategy and provides direction on how to build a strategy from the ground up, (or revamp your current strategy) including:

  1. The purpose of a Healthcare Social Media Strategy Handbook
  2. Creating your organization’s social media goals
  3. Defining a Brand Voice
  4. Using an Editorial Calendar

Part two focuses on content strategies for Facebook and Twitter and paid promotions. Part three focuses on social media crisis management and includes a daily social media to-do checklist that any healthcare organization can adopt, plus an editable template for your organization’s social media strategy handbook.

Over the last couple of years healthcare social media has become increasingly mainstream, particularly healthcare social media policyamong rare disease and specific disease state patient groups.  Patients use social media to learn how others cope with disease, to connect with others going through similar experiences and to gather information, among other uses.

Healthcare organizations use social media as an opportunity to gain real time information from patients, including feedback and preferences that help in tailoring marketing messaging.  Healthcare organizations also use social media to establish a service line or institution as an industry leader.  What was once a broadcast blast-it-out style marketing, healthcare marketing must now include patients in the process in order to be successful.  Noteworthy driving forces of this change include industry consolidation, consumer driven healthcare plans and a thriving patient engagement movement.

The purpose of a Healthcare Social Media Strategy Handbook is the following:

  1. Understand the purpose of your organization’s social media use
  2. Define the brand voice of your organization
  3. Create an editorial calendar and explain how to use it
  4. Create a content strategy for each social media platform your brand intends to use
  5. Define a social media crisis management policy
  6. Leverage paid promotions on social networks

Step One: List out all the major business objectives your organization could achieve on a social network.

  • Examples: sharing information, promoting services, increase traffic to organization website, gather customer information for future marketing efforts, learn about customer preferences

Step Two: Choose your organization’s social media priorities

  • Example: For 2015, Breast Care for Washington’s social media priorities are
    1. Build brand awareness so patients are aware of our services
    2. Build credibility as a best in class breast cancer screening services provider
  • These priorities are much different from our 2014 goals, when we were focused solely on raising funds to be able to open our doors and offer services.  This highlights the importance of integrating social media strategy with the over arching goals of an organization.   Messaging and goals must align.

Step Three: Define a brand voice.

Brand voice has a tone, a character,  a language and a purpose.

  • Tone: Will you communicate your content with an authoritative tone, a scientific tone, a personal tone?  Are your posts more like a conversation and less like a formal presentation?
  • Character:  Similar to tone.  Do you seek to inspire?  To inform?  To teach?
  • Language:  What words will you communicate your information?  Will you use industry terms?  Lay person terms?  Will your audience understand what you are posting?
  • Purpose: Are you attempting to engage, educate or sell your audience?

In choosing all these parts of a brand voice, it is important to keep the brand voice consistent across all platforms.  That means your brand sounds the same whether it’s tweeting 140 characters on twitter or posting a status on Facebook.  Consumers should interact with the same voice, regardless of the social media platform.

Reviewing all posts before they go live is important.  Having more than one person read them is important.  One misused hashtag and it could spell disaster for your brand, which we will discuss later in social media crisis management.

Step Four: Develop an Editorial Calendar

An editorial calendar is a tool that is used to organize social content. It helps with social media content planning to ensure that your brand always has content to post and that your brand is not repeating the same content over and over.  Editorial calendars are also a great place to track what content resonated with your audience, and what content needs to be better tailored to fit your audience or eliminated all together.  In the social media industry, we call this Key Performance Indicators (KPI).  KPIs include but are not limited to:

  • click-throughs to your website,
  • number of patients filling out your survey,
  • number of customers inputting data into a field,
  • number of likes, shares and comments.
  • Other engagement KPIs might be the number of retweets, mentions and replies a piece of content gets on twitter.

Finding an editorial calendar you like for your brand might not be easy.  There are great free editorial calendars for download that you can modify to fit your needs.  It’s important to determine the following information as you build your editorial calendar:

  1. Who will contribute to the content creation and editorial calendar?
  2. How many times a week will your organization post?  This will vary per social platform.
  3. Do you have the capacity to respond to patients in a timely manner, based off of the number of times your brand will post?
  4. Who will give final approval to postings?
  5. Do replies need approval before posting?
  6. Are your postings optimized for search engine optimization (SEO) opportunities?
  7. What holidays (domestic and international if applicable) will your organization post about?
  8. What upcoming events or services provided by your organization will be posted about?
  9. Are your posts HIPAA compliant? If no, do not proceed with the post.
  10. Have any patients mentioned in the post given consent for their information (name, event and service) to be included? Is documentation on file? If no, do not proceed with the post.

As you create your organization’s editorial calendar, it is important to remember that social media is social, and that responding to patient responses in a timely, professional manner, whether they are positive or negative is crucial for your organization to build credibility and an audience that is engaged.

Research has shown that organizations and brands that only sell to their audience are seen as less credible and less trustworthy than their counterparts.  Keeping this in mind, a best practice of social media strategy is to keep promotional posts to no greater than 25-30% of all posts.  While that might seem low, if all a brand does is shove their products down an audience’s throat, that brand can expect low engagement, or worse, unfollows and “hides” or “mutes” in their follower’s newsfeed.

To give you an idea of a social media algorithm that keeps promotional activity to 30% or less, here’s what we are throwing around right now at Breast Care for Washington:

  • Monday: Motivational Monday Quote (AM post), BCW related post (PM post)
  • Tuesday: Post about BCW services. Scientific Journal Article (PM post)
  • Wednesday: Great achievement in breast cancer (AM post), Funny post about going to the dr (PM post)
  • Thursday: Healthy foods for breast cancer patients/prevention, BCW related post
  • Fri: Fun activity happening this weekend in DC (AM post), Funny Meme (PM post)

The benefit of having an algorithm is your content creators (your producers) know what to look for, know what to create, and can fill the calendar in advance.  Keep in mind this algorithm should not be set in stone. As you track your KPIs you can see what types of posts, what type of language and what platforms are driving your success allowing you to tailor your messaging and content for future posts.

Taking time to plan and carefully develop an organization’s social media goals and editorial calendar will result in a sustainable social media plan that increases audience engagement, drives patient loyalty and increases revenue.  See you next time for Part 2: Content Strategies for Facebook and Twitter and Paid Promotions.


World Cancer Day: “Not Beyond Us”

Greetings from Las Vegas, NV!  PUGTATO is on travel this week and this is a quick post to tell you about a wonderful global event taking place today. (Sorry East Coasters, I know the day is almost over. The time change caught up with me!) February 4, 2015 is World Cancer Day.  World Cancer Day is an initiative led by the Union for International Cancer Control (UICC), which aims to reduce the global cancer burden, promote equity among cancer patients and put cancer control front and center on the global health agenda.  Founded in 1933, over 800 organizations spanning 155 countries are a part of UICC.

Every year cancer kills millions of people.  8.2 million to be exact.  What’s even scarier is that half of these moms, dads, brothers and sisters, aunts and uncles, are between the age of 30-69.  Cancer is a global crisis.  Deaths from cancer are expected to reach nearly 13 million per year without global commitment to changing patient outcomes.

World Cancer Day is an awareness campaign that shows each of us how we can contribute to reducing the global cancer burden.  Yes, that’s right, individually we can make a difference.  World Cancer Day also provides a show case for cancer solutions at all levels: institutional, provider, governmental.  It puts the spotlight on solutions that are working across the cancer patient circle of care and across many different cancer types and strives to directly impact solutions that we have not yet discovered.  World Cancer Day shows us that working together, we can make a difference.  Together, reducing cancer deaths is “Not Beyond Us.”

world cancer day, pugtato

This year World Cancer Day’s message focuses on four key components:

  1. Choosing healthier lives
  2. Delivering early detection
  3. Achieving treatment for all
  4. Maximizing quality of life

For more information please visit, and follow the movement online using hashtag #WorldCancerDay and/or #NotBeyondUs