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Using Social Media to Engage Colleagues, Healthcare Partners, and PatientsRadiologists at Cincinnati Children's Hospital use social media to engage colleagues, referring physicians, patients, and families.

Learning Objectives:
At the end of this activity, you will be able to:
1. List social media platforms to consider leveraging in your practice;
2. Discuss benefits and best practices of using social media in health care;
3. Identify which team members to consult in your social media efforts.
1 Credit

When Alexander J. Towbin, MD, associate chief of clinical operations and radiology informatics in the radiology department at Cincinnati Children's Hospital Medical Center, got the idea to use social media as a promotional tool, he initially planned to publicize his department's informatics projects. But Towbin quickly realized social media could serve an even broader purpose — promoting the entire department and increasing its visibility and influence along the way.

Alexander J. Towbin, MD, associate chief of clinical operations and radiology informatics in the radiology department at Cincinnati Children's Hospital Medical Center, leads the social media outreach initiative at Cincinnati Children's Hospital.

Alexander J. Towbin, MD, associate chief of clinical operations and radiology informatics in the radiology department at Cincinnati Children's Hospital Medical Center, leads the social media outreach initiative at Cincinnati Children's Hospital.

Under Towbin's leadership, Cincinnati Children's radiology department made its first foray into social media when it launched its Twitter account in 2013. Since then, the department has expanded its social media portfolio to include Facebook, the image-sharing networks Instagram and Figure 1 (a site exclusively for medical images), and a blog. The department leverages these communication channels to showcase its programs and distribute other imaging-related content directly to a diverse audience that includes patients, families, radiologists, and other medical professionals.

“Our department is doing a lot of fun and innovative work, like our immediate results reporting project for outpatient radiography and #MummyScan, a project that involved imaging the mummy of a Peruvian child that was on loan at the Cincinnati Museum Center,” says Towbin, who is also the Neil D. Johnson Chair of Radiology Informatics. “I thought the radiology community, our patients and families, and the general public would be interested in knowing about these projects, and social media provided the ideal platform for sharing this information.”

Towbin was right. Quiz Ref IDIn the three years since making its social media debut, Cincinnati Children's radiology department has attracted tens-of-thousands of followers, including more than 3,000 on Twitter, about 15,000 on Instagram, and roughly 7,000 on Figure 1. The department has also drawn more than 900 likes on its Facebook page and tens-of-thousands of views on its blog. “With social media, we have the potential to reach millions of people across different medical specialties, not just radiology,” Towbin says. “This amplifies our ability to improve outcomes for children.”

View a tip sheet for getting started with social media.

Building an Audience

While the hospital has institution-wide social media channels, Towbin thought the department should have its own accounts to publicize its value-added initiatives and empower its patients and their families to make more informed care decisions. “We were looking for ways to engage our patients and families better and to share the cool things our department was doing,” Towbin says. “Social media seemed like a good fit because it was free, it reached a large audience, and many of our patients' parents and many of the adolescents we care for use it.”

Until then, the radiology department traditionally promoted itself through academic papers and presentations. While these efforts have been valuable in their own right, Towbin saw the potential to further increase the department's standing through social media. “Ultimately, my goal was for Cincinnati Children's Hospital's radiology department to show up among the top search results whenever anyone Googled pediatric imaging topics,” Towbin explains. “To do that, I knew we needed a blog; but before we started a blog, we needed to cultivate an audience, and that was something we could do through social media.”

Learn more about the benefits of using social media in this Bulletin blog post.

With that in mind, Towbin, who already had some personal experience with social media, approached radiologist-in-chief Brian D. Coley, MD, FACR, about launching a department-wide social media outreach initiative. Towbin proposed establishing the group's first account on Twitter, because an increasing number of radiologists were using the platform. He recommended setting up the account in time for RSNA, which was just around the corner and would provide an immediate opportunity to begin building an audience from the scores of radiologists who typically engage on Twitter during the meeting.

Coley was a social media novice at the time but had no objections to the project. “Alex did his homework and clearly understood how to use social media as an effective engagement tool,” says Coley, who is also The Frederic N. Silverman Chair of Pediatric Radiology at Cincinnati Children's Hospital and professor of radiology and pediatrics at the University of Cincinnati College of Medicine. “We saw it as a way to generate recognition for the very good work that our team is doing and as a way to engage others to benefit patient care, which is our ultimate mission.”

Starting with Twitter and Facebook

With Coley's support, Towbin developed a one-page proposal outlining the radiology department's plans to use Twitter. The proposal stated that Towbin would be the only person tweeting from the account to ensure consistent messaging and that the posts would promote the radiology department's programs and educate its followers about appropriate imaging. Quiz Ref IDHe presented the proposal to the hospital's marketing team for approval.

“Most hospitals have a social media policy, and we wanted to make sure we weren't running afoul of that policy,” Towbin explains.

Quiz Ref IDFrom there, Towbin set up the account (@CincyKidsRad) and began tweeting about things like departmental research projects and sessions at RSNA and other educational meetings. “Every Monday, for example, I live-tweet (to post comments about an event while it's taking place) teaching points from our department's #WeekendReview educational conference, where we review interesting cases from the weekend,” Towbin says. Quiz Ref IDSuch daily content presented in catchy tweets that sometimes include pop-culture references, quickly attracted radiologists and other medical professionals — the department's target audience on Twitter.

The department uses its Facebook page expressly to promote its blog.

The department uses its Facebook page expressly to promote its blog.

As the department's Twitter followers began adding up, Towbin's next proposal was to launch a radiology department Facebook page. This time Towbin approached the marketing team with a plan to share content geared toward the Facebook page's intended audience of patients and families, including photographs of interesting events in the radiology department and articles from the mainstream and medical press that promoted the department. “The marketing team mainly wanted to ensure we'd have regular content and that it wouldn't become an orphaned page,” Towbin explains. That turned out to be a legitimate concern.

Towbin initially had trouble finding content to share with patients and families on Facebook. He'd post photos when the department installed new equipment or articles when the media covered pediatric imaging, but such occurrences were infrequent. Still, with members of the department often sharing the posts on their personal Facebook timelines, the department's Facebook page attracted a few hundred followers. It was enough to begin driving an audience to the third leg of the department's social media outreach efforts: a blog with content for patients and families.

Once the blog was activated in 2014, Towbin began using the department's Facebook page almost exclusively to promote the blog content. The approach provides consistent content to the Facebook page and directs followers to the blog, which now offers more than 500 posts under themes like, “Meet the Team,” “How We Do It,” and “Patient Stories.”

Read how the department maintains its blog.

Joining Instagram

Soon after the blog went live, University of Cincinnati radiology resident Saad Ranginwala, MD, joined Cincinnati Children's radiology department and saw an opportunity to expand its social media efforts even further. Ranginwala, who as a medical student started a Twitter account (@EDultrasoundQA) dedicated to educating followers about emergency medicine ultrasound, approached Towbin about doing something similar with the image-sharing site Instagram.

Saad Ranginwala, MD, radiology resident at University of Cincinnati, helps manage the radiology department's Instagram and Figure 1 accounts.

Saad Ranginwala, MD, radiology resident at University of Cincinnati, helps manage the radiology department's Instagram and Figure 1 accounts.

“At the time, Instagram was one of the fastest-growing social media networks, and many businesses were taking advantage of the visual medium,” Ranginwala says. “Since radiology is a visual specialty, Instagram seemed like a natural next step for our medical education efforts.”

Towbin was receptive to the idea and worked with Ranginwala to develop a plan for Instagram. They determined that radiologists throughout the department would help collect cases for Ranginwala to share each day with their target Instagram audience of medical professionals. They also decided that, for consistency, each image would focus on one concept and share one teaching point.

“We were a lot more thoughtful about our approach to Instagram than we had been with our initial social media channels in part because Instagram involved sharing images from actual cases,” Towbin explains.

Towbin and Ranginwala worked with the hospital's legal department to ensure sharing cases on Instagram wouldn't violate patient privacy regulations.

Read more about protecting patient privacy on social media.

Once the legal team signed off on the project, Towbin and Ranginwala asked volunteers within the radiology department to begin sending interesting cases to Ranginwala to share on Instagram. In general, the volunteers – who along with Towbin include A. Carl Merrow, MD, associate professor of radiology and Corning Benton Chair for Radiology Education, and Marguerite M. Care, MD, assistant professor of radiology, collect the cases in batches, write the captions to accompany the images, and then submit them to Ranginwala to post on a daily schedule.

Posting a unique case each day is challenging (no one wants to see pneumonia all the time, for instance), but with several people collecting cases, the team makes it work and draws thousands of followers in the process. “We get comments from parents saying, ‘This is what my child had,' and questions about the clinical follow-up for the patient,” Towbin says. “We also get comments from people who are clearly medically trained, asking detailed questions about the imaging study. So we know we have a mix of followers.”

While Towbin and his team don't respond to every comment on their Instagram and other social media accounts, they try to respond to any unfavorable comments they receive. “We get very few negative comments,” Towbin says. “But if a parent has a specific complaint, we try to address it directly with him or her offline. The way we respond depends on the medium. For example, on Twitter or Instagram, I send the user a direct message through the platform. Negative comments on our blog are tied to an email address, so in that instance, I communicate with commenters via email.”

Adding Figure 1 and Linking Accounts

After a few months on Instagram, the department's rich, consistent content attracted more than just casual followers. It also attracted the attention of the creators of Figure 1, who were so impressed with the department's Instagram feed that they reached out and asked the department to become one of the first hospital-based accounts on the image-sharing network for medical professionals.

“Figure 1 was fairly new at the time and was trying to gain traction, but we saw the immense potential in the platform and in being a featured partner,” says Ranginwala, noting that in 2016 alone, the department's Figure 1 account generated 17 million impressions.

The department's social media work, particularly on Instagram and Figure 1, has earned it multiple educational outreach awards.

The department's social media work, particularly on Instagram and Figure 1, has earned it multiple educational outreach awards.

Since Instagram and Figure 1 operate similarly, Towbin and Ranginwala share the same cases on both platforms. They also share the cases on the department's Twitter account, just as they share the department's blog content on both its Twitter and Facebook feeds. Such cross-linking means the accounts support one another.

“We use tools to link our social media accounts together, including a Facebook mechanism that automatically forwards posts to Twitter and a computer application called IFFT that automatically sends Instagram posts to Twitter,” Towbin explains. “This limits the amount of work each new platform requires, while ensuring our content reaches the largest audience possible.”

This smart use of engaging content has allowed the department to attract most of its followers organically, but it has also used low-budget advertising to draw some followers. One year, for instance, the department printed its Twitter handle and other social media accounts on business cards, which Towbin and others passed out during RSNA. The radiologists also include the department's Twitter handle on their posters and slides whenever they give presentations, encouraging viewers to follow the feed. “I don't know how effective these things are, but I have to think that they've played some part in spreading the word about our social media work,” Towbin says.

Benefiting the Group

While the department has generated an impressive number of social media followers, defining the value of any social media outreach initiative can be nebulous. It's difficult to know how social media impacts a patient's decision to seek care at a specific institution, for example. Still, Quiz Ref IDTowbin credits the department's social media efforts with elevating its status as a thought-leader in pediatric imaging and spreading the word about Cincinnati Children's imaging program much further than would have been possible through any other means.

The efforts have also attracted the attention of both the mainstream and medical press. In fact, Towbin credits the department's social media engagement with earning it a spot as a semi-finalist for Aunt Minnie's “Best Radiologist Training Program” award two years in a row, even though Cincinnati Children's Hospital primarily trains only pediatric radiology fellows.

“It's the result of our social media outreach with education,” Towbin explains. “We have people coming to us both nationally and internationally who say our Instagram account was the only thing they used to study for the pediatric part of their board exams. That tells me that, at least in that segment, we're doing it right.”

But perhaps more importantly, the department's work on social media and its blog is beginning to achieve the goal Towbin set when he started the outreach initiative — for the department to become a resource for anyone searching the internet for information about pediatric imaging. “In many cases, our content now appears prominently in the search results,” Towbin says. “That's satisfying, because it means people are reading our content and hopefully feeling more informed about appropriate imaging as a result.”

Key Takeaways:

  • The radiology department at Cincinnati Children's Hospital launched a social media outreach initiative to promote its work and have a positive impact on patient outcomes.

  • The department has attracted tens-of-thousands of followers through its social media accounts and blog, including radiologists, patients and families, and other medical professionals.

  • The department's social media efforts have bolstered its standing as a thought leader in the field of pediatric imaging.

Next Steps

  • Pick a social media platform and target audience to begin your social media outreach efforts.

  • Collaborate with your marketing, legal, and other stakeholder teams to ensure your social media efforts align with your institution's policies.

  • Based on your target audience, determine what type of content you will share on the platform, and develop a plan to ensure you have consistent content to share.

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ACR's Imaging 3.0 case studies series spotlights radiologists who are partnering with clinicians, other medical professionals, and patients to make the transition from a focus on the volume of scans read to the value of care provided. Each case study includes actionable steps that providers can follow to implement similar initiatives at their own institutions. Learn more

Article Information

This case study by American College of Radiology is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. Based on a work at www.acr.org/imaging 3. Permissions beyond the scope of this license may be available at www.acr.org/Legal.

Participation Statement: Upon completion of this activity, learners will receive a Participation Certificate.

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