Using the Internet to Assist Japan

On March 11, 2011, Japan was struck by a 9.0 magnitude earthquake – the fourth largest in the world since 1900 - proceeded by a massive tsunami. Reports indicate that at least 550,000 people have been displaced, and at least 10,000 have lost their lives. In the hours and days following these disasters, individuals and organizations have utilized the Internet as a “virtual crisis center,” using websites particularly social networking sites, to share information and locate friends and family members.

According to Ezra Gottheil, an analyst at Technology Business Research, “Social communications, like Twitter, and social networking sites, like Facebook, are at their best when big news is breaking.” As seen following the recent earthquakes in Haiti and Chile, humanitarian aid organizations have used social networking websites to solicit donations. Individuals have also used the sites to share information about their experiences on the ground and reconnect with friends and family members. Online Social Media, an organization which tracks social media services, reported that just an hour after the earthquake hit Japan, Twitter was experiencing 1,200 tweets per minute, many of them containing hashtags related to the tragedy. Facebook was similarly flooded with posts, which students in the U.S. and Japan are working together to use to paint a picture of the extent of the tragedy.

Large corporations have also created portals to help individuals locate loved ones and provide information about where to obtain medical assistance, food, potable water, and shelter. Google’s Person Finder database, available in Japanese, English, Korean, Chinese, and Portuguese allows users to enter a name and search for missing persons or post updates about people who they know are safe. A local version of the crisis-mapping tool, Ushahidi, has also been created and put in place. Ushahidi allows individuals in Japan to text or input online the locations of trapped people or clinic locations which are then plotted on a map so that users can easily pinpoint where people may be trapped, dangerous areas that should be avoided, and locations where food and clean water can be obtained.

Patrick Meier, director of crisis mapping and new media at Ushahidi, notes that “Ten percent of this [sharing of information] is the technology, and the other 90 percent is the people…That’s truer and truer as the technology gets easier to use.” As technology use and adoption becomes more widespread, the use of technology during the rescue and recovery period is likely to increase. By utilizing existing information and communication technologies and developing new ones, outcomes following natural disasters can be improved.



Click here to find out how you can participate in iCons in Medicine’s efforts to provide medical assistance via teleconsultations to Japan



FEMA Online Guide to Disaster Preparedness

Mobile applications that can prepare you for or provide assistance in a disaster situation:

• American Red Cross: Shelter View (iPhone – Free)


• Disaster Readiness (iPhone - $0.99)


• Disaster Readiness (Android - $1.99)


• Pocket First Aid & CPR (iPhone - $3.99)


• Pocket First Aid & CPR (Android - $2.99)


• Emergency Radio (iPhone - $0.99)


• Scanner Radio Pro (Android - $2.99)

Physicians Using Social Media

Individuals and organizations have embraced the use of social media as a way to quickly and easily create and disseminate information, ideas, and experiences, using low-cost, web-based technology. Doctors and others in the healthcare industry have been among those utilizing these new tools, but this use is not undertaken without some concern regarding matters of patient privacy and the blurring the lines between physicians’ public and private personas.

Robert L. Coffield and Joanne E. Joiner report that to date there are at least 540 hospitals in the United States using social media tools to communicate to a general audience. This figure includes 247 YouTube channels, 316 Facebook pages, 419 Twitter accounts, and 67 blogs, and these numbers continue to grow. Further research indicates that though nine out of ten U.S. hospitals are utilizing social media in some way, only one third have a formal social networking plan in place.

Twitter, which has an estimated 6 million monthly visitors, was ranked by Neilson.com in March 2008 as the fastest-growing site in the Member Communities category for the previous month. Among the physicians using social media, particularly Twitter, to connect with patients and colleagues, are a number of “celebrity doctors,” some of whom have more than 75,000 followers. In addition to these practicing physicians, social media and social networking websites are particularly popular among medical students, residents, and interns.

Researchers from the University of Florida’s colleges of Education and Medicine 2008 conducted a survey of the Facebook profiles of medical students and residents. Over 800 medical students’ names were searched on Facebook, and 44 percent of them were found to have profiles. Of these 362, only 37 percent had restricted the level of access to information contained on their profile by altering privacy settings. Additionally, a recent survey of medical school deans indicates that medical students have been found to frequently post inappropriate material on social networking websites.The findings, published in the Journal of the American Medical Association, show that 60 percent of the 80 deans who responded to the survey knew of incidents of unprofessional conduct, and 13 percent admitted to incidents that violated patient privacy.

David H. Brendel, MD, PhD, chair of McLean Hospital’s Institutional Review Board, has similar concerns for medical students’ disregard for protecting patient privacy when posting information on social networking websites. In Dr. Brendel’s case, this concern extends also to practicing physicians using Facebook and other sites, and he advises the following four guidelines for doctors when using online networking websites:

1. Address a patient’s online invitation immediately and in person to avoid damaging the therapeutic relationship.
2. Do not include information obtained through social networking websites to a patient’s medical record without their consent.
3. Use discretion when posting personal information online.
4. Understand the privacy policies available on social networking websites and use them to limit access to personal information.

Some healthcare providers chose to connect with patients not only through social networking websites, but also to exchange emails. Results of a 2009 study by Manhattan Research indicate that experts in “Physicians in 2012: The Outlook on Health Information Technology,”five specialties are most likely to contact their patients via email or online messaging: dermatology, medical oncology, neurology, endrocrinology, and infectious disease. indicated that five percent of approximately 9,000 U.S. adults who participated had send or received an email from a doctor, and 49 percent wanted to do so in the future. Additional data from Manhattan Research included in a report entitled

Many physicians are still reluctant to employ the use of email or social media to connect with patients because of privacy risks, despite the potential for beneficial physician and patient interaction. According to Robert L. Coffield and Joanne E. Joiner, even physician-to-physician contact through social networking websites can be problematic if the individuals involved are not careful to ensure that patient information and identifiers are not shared. To prevent some of these issues, telemedicine programs are sometimes utilized. Telemedicine is defined by Merriam-Webster’s dictionary as “the practice of medicine when the doctor and patient are widely separated using two-way voice and visual communication (as by satellite or computer).” It has grown since its first inception to include not only physician-to-patient contact, but also physician-to-physician Unlike standard, “public” social networking websites, iCons in Medicine is medical social networking and telemedicine website which allows doctors to request and send teleconsultations on difficult cases. To ensure patient privacy, iCons in Medicine relies on secure connections and one-on-one sharing of patient data.

Physicians who would like to provide or request teleconsultations can register online to take part in the program. Non-physician individuals with an interest in healthcare can also sign up to participate in the iCons in Medicine network as General Members.

Physicians Using Twitter

A recent report from Forrester Research indicates that the use of social networking websites among people aged 35 to 54 increased by 60 percent in the last year. Twitter and Facebook have become popular among federal centers like the Centers for Disease Control and Prevention (@CDCemergency), hospitals like the University of Maryland Medical System (University of Maryland Medical Center - @UMMC), and even individual doctors.

Through Twitter, doctors are able to post updates about the events of their day, connect with other healthcare workers, communicate with and inform patients, and even document surgeries and procedures. Results of a recent study by the American Telemedicine Association indicate that doctors and patients have seen beneficial outcomes from using Twitter to connect. Some healthcare providers, like pediatric gastroenterologist Bryan Vartabedian, MD (@Doctor_V), chose to use Twitter as a means to extend their web presence and communicate with existing and potential patients. Clinical nurse Phil Baumann notes additional medical uses for Twitter, including:

1. Disaster alerting and response,

2. Diabetes management including blood glucose tracking,

3. Drug safety alerts from the FDA,

4. Biomedical device data capture and reporting,

5. Shift-bidding for healthcare professionals,

6. Diagnostic brainstorming,

7. Rare disease tracking and resource connection,

8. Smoking cessation assistance,

9. Broadcasting infant care tips for new patients, and

10. Post-discharge patient follow-up and consultation.

Dr. Joseph Kvedar (@jkvedar), the Director of the Center for Connected Health and iCons in Medicine Member, describes Twitter as “a method of mass communication” that is real-time and “designed for mobility.” The ability to constantly update information also makes Twitter particularly appealing to government health organizations such as the United States Centers for Disease Control and Prevention (@CDCemergency) and the UK’s NHS (@NHSChoices). Using Twitter, these agencies are able to provide up-to-the-minute information regarding disease outbreaks, contact numbers to call for assistance, and other pertinent information. Medical associations such as the Radiological Society of North America (@RSNA), Healthcare Information and Management Systems Society (@HIMSS), and the Biotechnology Industry Organization (@BIOConvention) also use Twitter to keep their members informed about current news, promote events and meetings, and provide a sense of community.

While some providers use Twitter to connect with their patients and peers, others use it to provide information and updates during medical procedures. Recently surgeons in Iowa used Twitter to allow a woman’s family to follow the progress of her surgery in real-time. The Children’s Medical Center in Dallas provided updates when a father’s kidney was transplanted into his son, and the Henry Ford Medical Center (Henry Ford Health System - @henryfordnews) has tweeted during several procedures since January. These updates provide individuals who might not be comfortable watching a surgical procedure to still gain an understanding of the process and a chance to ask questions.

For the 61 percent of Americans who search online for medical advice, Twitter may not provide enough information. The social networking website Facebook allows healthcare workers or medical associations to connect with colleagues and patients. For the reported 55 percent of patients who want to be able to communicate with their doctors via email (according to a Manhattan Research study) it can offer another means of communication. Dr. William Cooper, a cardiothoracic surgeon, says that Facebook presents a way to always be available to his patients. According to Pauline Chen, MD (@paulinechen), it is unclear if engagement via Facebook and Twitter helps or hinders a patient-doctor relationship.

This concern is echoed by other physicians, including Dr. Sachin Jain, a resident physician at Bringham and Woman’s Hospital, who has accepted Facebook friend requests from patients, but “wondered about the appropriateness of the interaction.” In addition to the expectation that a physician would be “instantly available 24/7,” some doctors worry about the security of Facebook and other social networking websites, as well as potential HIPAA violations and litigation concerns. For many physicians, Facebook, Twitter, and other forms of social media are seen as “blurring the line between work and private life” - something that may cause some hesitation and discomfort.

Follow iCons in Medicine on Twitter or Join the iCons in Medicine Group on Facebook and Learn More About the Program

The New York Times on Twitter Users - USA Today/Science Fair on the Medical Uses of Twitter - Associated Press on Tweeting During Operations - On Medical Associations Using Twitter - Dr. Pauline Chen on Twitter - CNN on Physicians on Facebook - More on Physicians and Medical Professionals Using Twitter

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