This is part two of a multi-part series on independent physicians who have invested in, and have had success with, patient engagement.
No one could have ever guessed that Jeff Livingston, M.D., a partner at the Irving, Texas-based MacArthur OB/GYN, an obstetrics and gynecology practice with seven doctors and two mid-level providers, would be one of the leading advocates of provider-based social media interaction in the industry – not even Livingston himself. Yet today, he is a shining example of how doctors, other providers, and anyone else in healthcare shouldn’t dismiss Facebook, Twitter, or any other social media platform as simply just a marketing tool.
“In 2003, when I started in the industry, we were seeing a lot of young teenage pregnant faces, and I wanted to see why that was,” Livingston recalls. “There wasn’t much in the community at that time being done to help so I started volunteering at the high schools, and working my way through the politics of [teaching] sex education. I got approved and was giving talks on sexually transmitted disease prevention at the high schools. One night at home, I was talking with my teenager about how the talk went and she said, ‘Dad you should get a MySpace page.’”
With the help of his daughter, Livingston, who knew little about MySpace, built a page for his practice and put it up during his next talk. He says he hadn’t gotten back to his office when the questions started rolling in. Astoundingly, teens were asking private things and questions that had they been in his office, he says they probably wouldn’t have asked.
“In this space, they felt comfortable, and at that point, a light bulb literally went off,” he says.
Jeff Livingston, M.D.
Building a Community
Over the years, Livingston has poured time and energy into developing a vibrant social community for MacArthur patients on the web, using the rise of Facebook (1,676 likes on MacArthur’s page), Twitter (3,010 followers for MacArthur), and other platforms, to his advantage. No longer is the online platform a way to target STD prevention, he says, but instead it’s treated as an extension of his practice. Moreover, he recognizes that the electronic method of communication is the preferred means for a younger generation.
“As doctors, we don’t have to agree or disagree with that [method of communication], if we’re trying to engage patients, it’s not up to us how we do it. However patients want to get information, we should make it available to them,” Livingston says. In his opinion, as long as it makes your life easier as a doctor and leads to better care, it’s worth it. “For social media, it’s 100 percent yes to both of those.”
As an example, Livingston says his practice, located in a socioeconomically challenged urban area, was able to educate patients on birth control through social media and the web in general. Thus, instead of him spending eight minutes listing and describing options to his patients, they know and understand what they can use right off the bat.
In his opinion, too many of Livingston’s fellow doctors look at social media in terms of marketing, and how it can provide a return on investment (ROI). He says adding patients and ROI will come naturally if “your heart is in the right place.” That means making it fun and meaningful, making the provider look human, and overall, thinking about the experience of the end-user. Looking at social media from a marketing perspective without the end-user in mind, he says, won’t create a community or a dialog.
“That’s an advertisement,” declares Livingston, who says recently he has created meaningful Facebook dialogues on touchy subjects such as dealing with miscarriages. The information derived from these kinds of conversations, he says, make him a better doctor.
MacArthur’s patient engagement initiatives don’t end on Facebook, Twitter, or any other social media platforms. The provider also has a HIPAA compliant patient portal for its patients through Kryptiq (Beaverton, Ore.), which is integrated into its Vitera (Tampa, Fla.) EHR. The portal, Livingston says, provides MacArthur with a legal way to interact with their patients, and it goes hand-in-hand with the social media platforms.
“Having a portal is necessary if you’re going to be a Health 2.0 practice,” Livingston says. The Kryptiq portal has secure messaging, lab results, prescription refill, answers to anticipated questions, and other various capabilities. It makes his life easier and the patients’ lives because it provides instant, secure communication, as well as viable information.
Approximately 8,500 MacArthur patients are actively using the portal, according to Livingston. Two things have led MacArthur to have the largest active portal in Vitera software with an average of 60-70 new users per week, he says. One, everything is routed to the correct place, whether it be billing, scheduling, or anywhere else. A lot of the issues for portal usage he has heard of or seen come right from this routing problem.
The other reason for MacArthur’s success with patient portals is a trained staff, which according to Livingston is always telling patients about it. “You have to tell them it’s there, it’s funny how often that basic step often gets left out,” he says. “In our office, every step of the way, everyone in our office is trained to be on message about the portal.”
Patients, Livingston says, are given a pin number for their portal right when they check in, with set-up instructions attached. Everyone in his practice, from the doctors to the administrators, are constantly reminding patients to use it. There are even 10 big-screen panels in their waiting room with a running presentation on the portal, and how easy it is to use.
The enthusiasm never wavers from Livingston’s voice, and it’s clear that he’s not the type of guy that is going to stop at good enough. For the next act, he plans on using simple video technology to film MacArthur doctors conducting simple surgical treatments and options as a resource for its patients. It all goes along with his chief philosophy when it comes to Health 2.0 practices.
“We have an ethical duty as healthcare providers to help improve the type of material that’s available on the internet. When we know they are looking for it, we have an obligation to get them good information to them, and I hope more people do that over time,” he concludes.
Part 1 on the independent patient engagement series: Emphasizing the Patient in a Patient-Centered Medical Home