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How Twitter Is Transforming the Cancer Care Community

Butcher, Lola

doi: 10.1097/01.COT.0000364235.46286.c8

In the short time since Twitter burst onto the social media scene, cancer centers and advocacy organizations have come to use it as a valuable tool for building the community of those who fight cancer, with the microblogging service seen as an opportunity to see and be seen in a meaningful way that did not exist before the little blue bird flew onto their computer screens.

David J. Sampson, Director of Medical & Scientific Communications for the American Cancer Society, likens Twitter to a good professional conference that never ends. He learns what his colleagues are reading, what they are excited about, what they just learned, and what they think about topics of mutual interest. He says he can thus share information, clear up misunderstandings, engage individuals in one-on-one conversations, and advocate for positions he feels strongly about—all without ever leaving his desk.

“You get to see people you don't normally get to see and interact with them in a way that combines their personal approach and the typical professional working interaction—That's what I enjoy about it most.”

Sampson (@djsampson) tweets in his own account as well as two others related to the ACS's journals CA: A Cancer Journal for Clinicians (@CAonline) and @Journal Cancer. He and the rest of the ACS media team also tweet on @ACSNews.

“I came to Twitter sort of kicking and screaming, not understanding why I would care very much about what people are doing at their desks,” he said. “But once I saw what it could do, it became an integral part of my work.”

Created in 2006, Twitter is forecast to have 18 million users—or about 11% of all Internet users—by year-end, according to the research firm eMarketer. That is roughly double the number of users in 2008, and rapid growth is expected in 2010.

Tweets, which can be sent via mobile devices or the Web, must be no more than 140 characters in length, and considering that that allows very few words, the ways in which people use the microblogging service are remarkable.

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Engaging Physicians

At the University of Texas M. D. Anderson Cancer Center, John W. Little, Program Manager in the Office of Physician Relations, considers Twitter to be an essential component of his strategy to connect with physicians who need to refer their patients to a cancer center.

Earlier this year, his office launched a Web site——to create a community hub for referring physicians and M. D. Anderson specialists (see accompanying article).

“Twitter is our highest external source of traffic to that Web site,” said Little (@PhysRelations). “Our group is using it specifically to reach physicians and folks around the physicians—both those in the general health care professional audience and media associated with health care.”

In addition to connecting with referring physicians, Little also uses Twitter to help M. D. Anderson physicians engage with colleagues and the public. While only a handful of Anderson physicians are tweeting so far, he said he expects that to grow as the benefits to both the physicians and the institution become increasingly apparent: “Being out in that arena where we can promote their work generates a lot of good will.”

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To Help with Communications

Cynthia Floyd Manley (@ManleyatVICC), Associate Director for Communications at Vanderbilt-Ingram Cancer Center, uses Twitter to extend her primary role at the cancer center. “I see it as an extension of my role as spokesperson for the organization, cheerleader, advocate, and supporter of the center and cancer research and survivorship,” she said.

She plans to use Twitter to identify and connect with lung cancer patients who might qualify for an upcoming clinical trial. The trial involves never-smokers who have lung cancer and, because registration is Internet-based, people from all over the country can participate.

“We're going to be using Twitter and going into Facebook to find those conversations where people who are interested in lung cancer and are maybe lung cancer survivors are gathered. And we plan to use those mechanisms to reach them and get them information about the study.”

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To Engage in Conversations

At ACS, Sampson credits Twitter with helping him break through a longstanding communication problem: “For years, we were misquoted as saying that we recommend routine screening for prostate cancer, although what we recommend is that men make this choice with their doctor,” he explained. He uses Twitter to look for opportunities to highlight ACS recommendations or clear up misinterpretations—and, in the case of prostrate screening, he found success.

“Now there are several in the blogosphere and in mainstream media who point out that the American Cancer Society does not recommend routine screening, that we recommend that men discuss the matter with their doctors. That has been such a hard point to make, and Twitter was a way to get to the thought leaders and alert them that we had a point of view on this that was a little different than they believed.”

Twitter also helped ACS counter the misimpression that, since the cancer mortality rate is similar to what it was at the beginning of the War on Cancer, that no progress has been made. That analysis ignores the fact that the mortality rate rose for two decades after 1971 before it started to decline by a one to two percent drop every year.

“It just sounds like PR when you put that in a press release, but if you can start having a discussion about it and point out where people mis-portray it, reporters are interested,” Sampson said. “In the end, reporters were tweeting that this was a misrepresentation of facts about cancer mortality trends.”

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To Find Out What People Think

One of Manley's colleagues at Vanderbilt monitors the Twitter buzz about the medical center. Whether the tweets are positive—“We see a lot of compliments where people talk about how great the care is here”—or negative—“Heading to Vanderbilt. Wish me well in the parking garage!”—the communications department wants to know.

If the tweet has been posted by a follower, a Vanderbilt representative will send a direct-message as soon as possible.

“We always try to respond to those and let people know that we appreciate the feedback,” Manley said. “If it's positive feedback, we'll share that with the team; if it's negative feedback, we thank them for bringing it to our attention and give an e-mail address to seek additional details because we are always looking for ways to improve.”

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To Support Professional Colleagues

Colleen Karuza (@ColleenAtRPCI), Public Relations Director at Roswell Park Cancer Institute in Buffalo, NY, estimates that 70% of her tweets are sharing resources—that is, posting a link to an article or report or driving followers to information on the Roswell Park Web site—and that 20% are related to engagement, either by direct-messaging someone in response to a Twitter post or participating in a Twitter conversation.

The remaining 10% of her tweets fall in the “chit-chat” category, she said, but that does not mean they are not valuable. Some 1,400 people follow her on Twitter, and a small group of them—most of whom work at other cancer organizations around the country—have become important people in her professional life.

“One of the benefits I have experienced is the relationship-building and networking with colleagues and journalists,” said Karuza, who also routinely contributes to Roswell Park's primary twitter accounts (@RoswellPark and @yRoswell) maintained by members of the Institute's Marketing Department. “I have a small circle of cancer tweeters that have evolved as my front-line go-to people.”

Those are the people she knows will always read her tweets, answer questions, and spread her information farther through “re-tweets”—i.e., resending the information to others. She returns the favors.

“If they have an important research finding, an upcoming special event, or something of interest to the global cancer community, I'll often re-tweet it on my profile. The more information we get out there and the more awareness we build, the sooner we can imagine a world without cancer.”

© 2009 Lippincott Williams & Wilkins, Inc.
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