How many Filipinos are on Twitter? PeerReach, a social media analytics firm computed the proportion of people using Twitter per number of people using the Internet in a particular country. This number, the Twitter penetration rate, was 4% for the Philippines. In 2012, the Philippines ranked 10th on Twitter with 9.5 million Filipinos among Twitter’s 517 million users then in a survey by Semiocast.  I wonder how many Filipino healthcare professionals are on Twitter? A ZocDoc survey found that 21% of US physicians reported using Twitter.

The #HealthXPh chat on March 22, 10 am Manila time will discuss the use of Twitter in healthcare. Everyone is welcome to join us, please check time zone differences here.

T1 Why did you join Twitter? Was being a healthcare professional a cause for concern?

I joined Twitter June 2010 as an assignment for my informatics class in graduate school. I wasn’t warned about being careful as Dr. George Lundberg reminds us -

Be super careful, not only in evaluating the Tweets that you receive, but especially the nature of what you Tweet.

Spur of the moment thinking that becomes identified as your Tweet could haunt you for a long time.

Retraction, deletion, or “de-Tweeting” may not be as easy as it seems.

If one is so afraid of tweeting, how about just retweeting then? An interesting study by Ji Young Lee and S. Shyam Sundar found that original tweets by doctors were perceived as credible but not retweets from other doctors.

T2 Has being on Twitter helped you as a healthcare professional or as a patient? If yes, in what ways?

Dr. Anne Marie Cunningham (@amcunningham) enumerates ten reasons for doctors to explore social media in this presentation – Why does a Twittering Doctor Tweet? 10 reasons to have a social media presence. Perhaps, Twitter has helped you in one of the ways she has listed. Brittany Chan shares why she uses Twitter in this post on – Twitter makes me a better doctor: 4 reasons why I use Twitter:

1. Stay up to date on news and literature.

2. Share ideas and learn from others.

3. Help patients.

4. It’s fun!

T3 Enumerate ways that Twitter is used in your healthcare setting.

Phil Baumann wrote 140 Health Care Uses for Twitter way back in 2009. Which of these are happening where you are? We just might extend this list further!


In 2010, the American Dialect Society chose “app” as Word of the Year. This is perhaps a testament to the ubiquity of mobile phones and the apps that make it useful. App is of course, short for “application” though I think no one called it that until the iPhone 3G ad in 2009. I certainly didn’t when I first started using a mobile device (then called a PDA or personal digital assistant) as a medical resident in 1997, the Palm Pilot Pro. One of the earliest apps then was Epocrates, a drug database. Palm Pilots have gone the way of the dinosaurs as mobile phones became smartphones which could run apps. There are many apps now available for use by both doctors and patients. Joseph Conn writes that medical apps are no longer a novelty today and I agree.

For this week’s #HealthXPh tweet chat on March 15 (10 am Manila Time), the discussion will focus on the use of medical apps by healthcare providers and patients.

T1 What questions do you need to ask before downloading a medical app?

Visser and Bouman (Student BMJ, 2012) warn that “doctors should be wary when using medical apps.” They raise the following points:

  • In case of malfunction, an app can be “recalled” but that only prevents new downloads.
  • Apps that collect patient data pose a risk to confidentiality.
  • Apps that are used in clinical decision making should be peer-reviewed.
  • Drug company-sponsored apps raise the issue of conflict of interest.


T2 Should healthcare providers prescribe medical apps?

There are a bewildering number of medical apps available for patients. Should healthcare providers sift through these apps and help patients decide which medical apps are useful? Would healthcare providers be liable if patients are harmed from using these apps? Jonah Comstock reports in mobihealthnews  -

A staggering 90 percent of chronic patients in the US would accept a mobile app prescription from their physician, as opposed to only 66 percent willing to accept a prescription of medication, according to a recent survey from health communications firm Digitas Health.

Interestingly, there is a prescription-only, FDA-approved app for those with type 2 diabetes called BlueStar, developed by WellDoc.


T3 What kind of apps should FDA regulate?

In Sept 2013, the FDA issued the final guidance for mobile medical applications. In that document, only apps that are intended to be used as an accessory to a regulated medical device or transform a platform into a regulated medical device will be regulated. For apps that pose minimal risk to patients and consumers, FDA will exercise “enforcement discretion” only. This means that manufacturers will not be required to register these apps with FDA. These include apps that:

  • Help patients/users self-manage their disease or condition without providing specific treatment suggestions;
  • Provide patients with simple tools to organize and track their health information;
  • Provide easy access to information related to health conditions or treatments;
  • Help patients document, show or communicate potential medical conditions to health care providers;
  • Automate simple tasks for health care providers; or
  • Enable patients or providers to interact with Personal Health Records (PHR) or Electronic Health Record (EHR) systems.