Improving How Your Clinic Communicates with Twitter

Issue Number: 
Volume 4 Issue 1 - January 2010
Matthew Livingston R.N. B.S.N C.W.S

Twitter is a growing communication technology that is widely used in the United States and throughout the world. This growth includes the expectation of more than 100 million active users worldwide by the end of 2010.1 Twitter enables individuals to send short messages (up to 140 characters long) to anyone that signs up to follow that particular account holder. These messages can connect people with similar interests via the internet, mobile internet, and short message service (SMS) text messaging. Many people use Twitter as a way to receive information from various sources of interest. Increasingly, though, health care and wound care professionals are finding value in setting up their own Twitter accounts and sending out their own streams of information. Some major uses of Twitter for the health care professional include the following:

1.Peer-to-peer communication
Starting your own Twitter account and sending out your own tweets can connect you with potentially vast numbers of individuals. This includes wound clinics and clinicians who are interested in sharing ideas and networking. The conversation can include:

- Providing occasional updates for what you are doing in your clinic to improve patient outcomes.
- Sharing (Re-tweeting) interesting articles from the major wound related tweets such as those found in Today’s Wound Clinic, Wounds, and OWM journals.
- Asking your group for feedback on how to solve a particular clinic or patient related problem.

2. Promoting your clinic blog or website
One advantage of using Twitter to promote your work is that Twitter can connect you not only to your list of followers but to their followers as well. Someone receiving a tweet can forward that message on to his or her list of followers (and so on). This is referred to as a viral loop because of the ease and speed with which information can be spread.2
Another advantage of promoting a blog or website on twitter is the added benefit for followers who receive updates of new articles as they are submitted. If the title sounds interesting the reader can click the URL for the full text of the blog or website to appear.

3. Connecting with potential patients:
There are also a growing number of wound care clinics and physicians that have embraced twitter. Many in this group have realized the Twitter’s age-related demographics matches well with the typical age of patients seen in wound clinics. In February of 2009, there were over a million (1,165,000) 55 to 65 year old unique United States visitors to Matched with what clinics see as the mean age of 60.4 (taken from a sample of around 20,000 patients served by Intellicure's EMR Program).4 There is also a trend that shows a considerable increase of 35 to 49 year old Twitter visitors at just under three million (2,935,000).3 This group is well positioned to use Twitter for wound related information in the future.
Currently over 190 hospitals and hospital systems (including the Mayo Clinic, Scripps Health, and Alegent Health)use twitter as a branch of their marketing plan.5 These hospitals are reaching out to the American adults who are looking for supplemental health information. This includes searching for information pertaining to treatment options, physicians, and medical facilities.6 Tweets can highlight events that include patient information lectures or ask the doctor question - answer sessions.

4. Patient satisfaction
There are several approaches to enhancing how the clinic can improve patent satisfaction using Tweeter. This includes:
- Clinics with high patient volumes can improve patient satisfaction by giving status updates on clinic delays.
- Provide research updates on new research based on a patient’s etiology.
- Provide scheduled reminders for select sub groups in wound care.

Note: that in order to stay compliant with Privacy and HIPAA regulations it is important to insure that the privacy settings on Twitter are activated. To do this, go to the twitter list page of your Twitter account. After clicking “new list” a prompt will offer you the ability to turn on the privacy feature. This feature will only allow the creator of the private lists to see or subscribe to them (not even those on the list can see private lists).7

Final Thoughts
My hope in writing this article is to encourage more clinicians to join the conversation on twitter, to share their resources and ideas for how to improve patient care and clinic operations. For those who choose to join the conversation the advantages of joining Twitter will be significant, including an inexpensive opportunity to reach out to current and future patients. Twitter will also benefit wound clinics, clinicians, and their patients as it continues to connect those interested in sharing and advancing their clinical insights.

Twitter Terminology
Tweeter/Twitterer: an individual who uses Twitter.
Tweets: short posts that Twitter members write.
Following: subscribing to someone's tweets.
ReTweet: is a repost of another individuals Tweet. Attribute the post to the original author by preceding the username with "RT" and "@”.
#: The hash tag sign allows Twitter users to group tweets by keyword topics and phrases, allowing for an easier monitor particular conversations using Twitter Search.
@reply: the At Reply is a direct tweet reply sent to a specific Twitter user. For example - Reply to @[username].
Link: including the URL in your tweet.
URL: the address of a specific web page on the internet.

Useful Twitter Apps
Tweetdeck ( is a free browser that allows for the organization of individual twitter members to be grouped by: referring physicians, doctor's census, and patient’s typical visit day. Tweetdeck allows for messages to be sent to one or more segments of that group.

Hospital public relations officers with large volumes of tweets (related to a busy event calendar) may prefer Socialoomph ( which is an application that allows advance scheduling of tweets.

Twitterfeed ( automatically sends clinician blog updates to twitter accounts via an RSS feed.