Kaiser Permanente has released the results of a new data analysis focused on how physicians, health reporters and policymakers talk about health. The analysis found significant differences among the three groups studied, underscoring a need for greater alignment among key influencers around pertinent health issues impacting Americans. The data was shared at an event Feb. 26 at the Kaiser Permanente Center for Total Health in Washington, D.C.

1. American Voices – Aligned for Health
Greg Matthews
February 26, 2013
Contents are proprietary and confidential.
#AVA4H | @chimoose
1

2. My use of twitter allows me to expand the diversity of my
network, and therefore my knowledge in my areas of
interest : prevention, diversity/equity, integrated care, and
Washington, DC (the #epicenter!).
It also allows me to model open leadership as a physician,
and promote this approach among my medical and
nursing colleagues.
Ted Eytan
Family Medicine, Kaiser Permanente
twitter.com/tedeytan
linkedin.com/in/tedeytan
tedeytan.com
Contents are proprietary and confidential.
#AVA4H | @chimoose
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3. Internet users are searching for health info
72%
140 Million American Adults
Pew Internet and American Life – Online Health 2013
3 Contents are proprietary and confidential. #AVA4H | @chimoose

4. Self-diagnosis is mainstream
35%
of internet users are
considered “self-
diagnosers”
Pew Internet and American Life – Online Health 2013
4 Contents are proprietary and confidential.
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5. Twitter is an information accelerator
• 25% of physicians use social media daily as an information
source*
• Facebook has passed 1B users;
• Twitter has surpassed 500M Users
Journal of Medical Internet Research – September 24, 2012
5 Contents are proprietary and confidential. #AVA4H | @chimoose

6. Tweets Over Time
Trending steadily upward
4500
4000
3500
3000
2500
2000
1500
1000
500
0
1 11 21 31 41 51 61 71 81 91 101 111 121 131 141 151
6 Contents are proprietary and confidential. #AVA4H | @chimoose

7. The American Voices study
7 Contents are proprietary and confidential. #AVA4H | @chimoose

8. AVA4H Data Sets
2.3M 132,108 464,272
218,934 36,300* 71,606
*Journalist-written articles
8 #AVA4H | @chimoose

9. 5,000
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11. 403,000
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12. 12 #AVA4H | @chimoose

13. 2,300,000
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14. 14 #AVA4H | @chimoose

15. Not just tweets this time …
326,840
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16. 16 #AVA4H | @chimoose

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19. Making Sense of the Data
19 Contents are proprietary and confidential. #AVA4H | @chimoose

20. Topical Breakdown
• CDC Disease list
• Broad Health Topics from
Subjects’ tweets
20 #AVA4H | @chimoose

21. What we Learned
21 Contents are proprietary and confidential. #AVA4H | @chimoose

22. At the highest level …
Health Education
Business of Health
Politics of Health
Contents are proprietary and confidential.
22 #AVA4H | @chimoose

23. At the highest level …
Health Education
Business of Health
Politics of Health
Contents are proprietary and confidential.
23 #AVA4H | @chimoose

24. Strongest Focus Areas
Healthcare Conversation Topics
100%
90%
23% 15%
Percentage of Healthcare Conversation
80%
47% 5%
70% 10%
15%
60%
Treatment
6% 22%
50% Research
40% Prevention
27% 11% Policy
30%
64% Business
20%
14% 33%
10%
6%
0%
Doctors 2%
Media
Congress
24 #AVA4H | @chimoose

25. Where education makes a difference
25 #AVA4H | @chimoose

26. Making a comeback
Contents are proprietary and confidential.
26 #AVA4H | @chimoose

27. A new #1
Vaccine-Preventable Diseases
27 #AVA4H | @chimoose

28. Doctors armed for combat
Contents are proprietary and confidential.
28 #AVA4H | @chimoose

29. Disease Conversation Volume Over Time
100
90
80
70
60
50
40
30
20
10
0
Diabetes Breast Cancer Prostate Cancer
29 Contents are proprietary and confidential. #AVA4H | @chimoose

30. The PSA Controversy
36
117
Doctors who state an opinion are
more than
3:1 Against
the USPSTF’s 182
ruling on PSA Tests
Negative Neutral Positive
30 Contents are proprietary and confidential. #AVA4H | @chimoose

31. The Voice of the Patient Matters
31 Contents are proprietary and confidential. #AVA4H | @chimoose

32. Doctors discuss Breast Cancer and Lung Cancer
100%
90%
80%
70%
60%
Breast Cancer
50% Lung Cancer
40%
30%
20%
10%
0%
Mortality/1,000 Conversation Frequency
32 #AVA4H | @chimoose

33. HIV/Aids and Heart Disease
100.0%
80.0%
60.0%
40.0% AIDS/HIV
Heart Disease
20.0%
0.0%
Contents are proprietary and confidential.
33 #AVA4H | @chimoose

34. Vaccines - HPV
HPV makes up 18.2% of media vaccine conversations
100% 4.2%
90% 18.2%
80%
70%
60%
95.8%
50%
40% 81.8%
30%
20%
10%
0%
Doctors
Media
Other Vaccine Conversation HPV
34 #AVA4H | @chimoose

35. Content Gap Analysis Methodology
Corpus 1 Corpus 2
• The Content Gap Analysis is
a statistical comparison of
word frequencies between
147 documents 80 documents two corpora of text
1,789 words 917 words
• These two corpora are
typically either:
• A subset of one corpus
compared against the
Word Frequency Word Frequency
whole corpus
medicine 10 vaccine 6 • Two distinct corpora
compared directly
ƒ(x)
drug 8 medicine 6
vaccine 7 drug 4 against each other
vaccination 7 vaccination 3
wellness 6 health 2 • The outcome is a list of
words that appear in both
corpora with an associated
Word G2
“oddness” score that
medicine 3.42
denotes how much more (or
drug 2.81 less) each word appears in
vaccine 1.14 one corpus versus the other
vaccination 1.12
35 #AVA4H | @chimoose
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36. Interventions – MDs and the Media
36 #AVA4H | @chimoose

37. The untouchable – and the social?
37 #AVA4H | @chimoose

38. Medicaid and Mandela
38 #AVA4H | @chimoose

39. High Risk/Low Effort
• Doctors discuss 67% more than the media;
• 483% more than congress
39 #AVA4H | @chimoose

40. Insurance and reimbursement
• Congress & the media lead the way in exploring how we’ll
pay for care in the future
• Physicians, while concerned about patients’ access to care
and the viability of primary care, can be better informed
14%
48%
Doctors
38% Media
Congress
40 #AVA4H | @chimoose

41. Aligning communications – what’s next?
• Patient-centeredness
first
• Create more robust and
transparent networks
(inter- and intra-group)
• Build consensus on the
balance between “most
important health stories”
• Monitor progress with a
public “dashboard”
41 #AVA4H | @chimoose

42. Thank you
#AVA4H | @chimoose

43. Acknowledgements
Analytics Design – Seth Duncan (@PRResearch)
R&D Lead – Matthew Hager (@iSmashew)
Analyst – Kayla Rodriguez (@Kaylarodrigue11)
Analyst – Dan Zhao (@denzelzhao)
Analyst – Emma Ferguson (@EmmaAnAnalyst)
#AVA4H | @chimoose

44. #AVA4H | @chimoose

45. Appendix
#AVA4H | @chimoose

46. Physician Profiles
78 %
identify
themselves
clearly as
such in their
twitter bio
32 %
link to a personal blog
or website
80 %
contain a
URL in their
bio
46 Contents are proprietary and confidential. #AVA4H | @chimoose

47. How are MDs using their accounts?
Bio URL Distribution
6.90%
1.90%
93 %
of all Plastic Surgery
37.70%
URLs are links to their
practice
31.90%
Business Medical Resource Personal Blog/Website Practice
47 Contents are proprietary and confidential. #AVA4H | @chimoose

48. Twitter and the MD Workflow
Localized time
Morning Workday Work PM Evening Overnight
(0500 – 0800) (0801 - 1200) (1201 - 1800) (1801-2300) (2301-0459)
18 % 21 % 31 % 8% 22 %
31%
21% 22%
18%
8%
0500-0800 0801-1200 1201-1800 1801-2300 2301-0459
48 Contents are proprietary and confidential. #AVA4H | @chimoose

49. The Connected Physician
49 Contents are proprietary and confidential. #AVA4H | @chimoose

50. Ratio of following to followers
Ratio of Following to Followers
32.40%
Median
21.50% Ratio
1.1 : 1
16.20%
14%
6.70%
4.90%
2.80%
1.60%
0.- .1:1 .11-.2:1 .31-.7:1 .71-1.5:1 1.51-3.0:1 3.1-11.0:1 11.1-100.0:1 100.1-2808:1
50 Contents are proprietary and confidential. #AVA4H | @chimoose

51. MDs Most likely to be followed by peers*
25%
53%
Personal Blog/Website
27% Business/ Organization
All_Doctors
No Bio URL
practice
34%
40%
*Percentages measure MDs followed by at least 20 others in the data set
51 Contents are proprietary and confidential. #AVA4H | @chimoose

52. How connected are online physicians?
%
34 of all MDs are followed
by at least 20 MDs
Pediatrics
Specialties who Emergency
are followed by Medicine
other MDs
Family
Medicine
52 Contents are proprietary and confidential. #AVA4H | @chimoose

53. Mining the Data
A sample
• Breast Cancer: (breast AND (cancer OR carcinoma)) OR (inflammatory AND
breast) OR (inflammation AND breast) OR (breast AND (metastasis OR metastic))
OR (duct AND (carcinoma OR cancer)) OR (lobe AND (carcinoma OR cancer))
OR "DCIS" OR "LCIS" OR (estrogen AND receptor AND positive) OR "HER2" OR
(breast AND MRI) OR (breast AND biopsy) OR (breast AND ultrasound) OR
"mammogram" OR "mammography" OR "tamoxifen" OR (aromatase AND
inhibitor) OR "exemestane" OR "trastuzumab" OR "Herceptin" OR "lumpectomy"
OR "mastectomy" OR "komen" OR "BRCA1" OR "BRCA2”
• Diabetes: "Diabetes" OR "Mellitus" OR "Insipidus" OR "Diabetic" OR "Gestational"
OR "blood glucose" OR "Blood Sugar" OR "NIDDM" OR "IDDM" OR "LADA" OR
("Antiduretic Hormone" OR "ADH") OR ("Arginine Vasopressin" OR "AVP") OR
"oral glucose tolerance" OR "fasting plasma glucose" OR "glycated hemoglobin
OR HbA1c OR A1c" OR "insulin" OR "SMBG" OR "hyperglycemia OR
hyperglycemic" OR "biguanides" OR "Sulfonylureas" OR "Meglitinides" OR
"thiazolidinediones" OR "alpha glucosidase inhibitor" OR "GLP-1 agonist" OR
"DPP-IV inhibitors" OR "DKA" OR "HHS"
53 Contents are proprietary and confidential. #AVA4H | @chimoose

54. Diabetes & Breast Cancer – Sample Search
Contents are proprietary and confidential.
54 #AVA4H | @chimoose