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The Mayo Clinic wasn’t sure what to expect from social media when it gave it a test run four years ago.

Things like iPods, MySpace and blogs had exploded onto the social scene, and businesses were looking to cash in. But the health care industry had other considerations, and more rules to play by.

The interest was not exclusively marketing and advertising, but rather how to use the technology to transform the access, delivery and dissemination of health information. And then there were other issues like patient confidentiality and related privacy issues.

Mayo started with a podcast, largely unsure of what it was doing. There was no staff dedicated to new media, so a few of the public affairs employees hastily podcasted a 60-second broadcast radio feed normally provided to radio stations.

Then they waited. Then they watched as a few listeners grew to some 76,000 in one month. They knew they were on to something.

“It was us dipping our toe in to see if this is something people actually do and can we do it,” said Lee Aase, Mayo’s manager of syndication and social media based in Rochester, Minn. “We were somewhat surprised to see our podcast featured on the front of the iTunes store, so that was kind of a ‘Wow’ moment.”

Mayo Clinic, which has a campus in Jacksonville, has come a long way in just a few years, since adding a Facebook page with more than 3,000 friends, a YouTube channel with videos of doctors talking about illness, treatments and research, a health blog for consumers and another for media to improve the process of medical reporting. It’s also creating “secret groups” on Facebook to connect patients to others with similar illnesses, an area it hopes to expand in the future.

But that’s just the tip of the iceberg in the brave new world of Health 2.0.

The Internet in its infancy, or 1.0, was all about accessing information. Think WebMD. But where Web 2.0 describes the onslaught of user-generated content like Wikipedia or Yahoo Answers, Health 2.0 is defined by the use of social software and its ability to promote collaboration between patients and the rest of the medical industry.

Having a company Web site is so five years ago. Social media — the umbrella term for blogs, social networks, photo video and podcasts, and other user-generated mediums — is the new era. And the possibilities are seemingly endless.

Try a virtual existence in Second Life. The Centers for Disease Control, Partners HealthCare System and CIGNA Corp. all have active pilots to test scenarios and study behavior in the virtual world.

Then there’s Medscape, a social network for doctors that has a format similar to MySpace or Facebook and includes 100,000 physicians. It’s similar to its predecessor, Sermo, and both are exclusive to verified physicians.

Recent forum discussions on Medscape range from gossip about a colleague dating a patient and complaining about the frequency of patients who request a note to be excused from jury duty to more serious topics such as concern over a baby mix-up and how to avoid malpractice lawsuits.
Mood diary

But over at Realmentalhealth.com, patients come together to chat and blog about their illness, support each other with recommendations, like to check out an article on celebrities with bipolar disorder or use a mood diary to track symptoms, and post local events like 12-step meetings and invite others to attend.

Martin Ogawa started Real Mental Health Inc., based in Miami, after working in the information technology industry. Ogawa said when the site went live in 2006, it was the first of its kind, but by 2008, social media in health care had exploded.

“More health care companies adopted some sort of social media in 2008, and that’s a good step,” Ogawa said. “It’s good for the industry and it’s good for patients, but most importantly, it’s focused on treatment and wellness, and makes it easier for everyone to accomplish that goal.”

Just like the Internet itself, there are potential downsides when there are few controls. One of the early social networks on health topics was a pro-anorexia site where users worship scary-skinny celebrities, exchange tips and tricks that enable their diseases and hide it from others. It became a cult phenomenon with its own name — “Ana,” as in anorexic — and has spawned other copycat sites.

There are also sites where those contemplating suicide can solicit tips from others in the network, and get blood-curdling advice. The British Medical Journal reported in 2008 that people researching suicide are more likely to find sites that promote it than sites that provide help and support, and many of those sites are forums or other user-created content.

Health officials entering the dialogue could change that. Aase said Mayo-led discussions of diseases are popping up earlier in searches.

“I was just looking at a blog post that we had on Potts Syndrome. It’s a 20-minute discussion that has 45 comments and has been viewed thousands of times for a relatively obscure condition,” Aase said. “The great thing about social media is you can produce content for people who have that condition and want to be better-informed patients or family members who want to educate themselves.”

But it’s not all just about talking about disease.

Nemours, the Jacksonville-based children’s health system, has used social media in the process of creating its upcoming hospital in Orlando. It established a blog for its family user group to make recommendations on the design of the hospital, which breaks ground next month. Nemours also has a two-year-old viral media campaign featuring parent testimonials and podcast speeches by Chief Executive David Bailey.

“For now, our focus is the Central Florida market, but we will expand this into other areas in the future,” said Odette Struys, spokeswoman for Nemours.

And the American Red Cross is big on Twitter, sometimes referred to as micro-blogging. It used Twitter in 2007 to send minute-by-minute updates on California wildfires, deliver aid and raise money. It now regularly uses Twitter to post updates on storms and natural disasters.

Setting up most social media accounts is free, but depending on their use, they may require part- or full-time management. Mayo Clinic implemented all of its social media for less than $1,500, Aase said.

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