Using a Private Label Twitter Network for Doctor-Patient Communication?

I just read this article about a new generation of Twitter-like tools that allow organizations to maintain private Twitter networks. So I got to thinking what it might be like if a clinician and their patients set up one such network. Kind of like a group visit. I created a mockup, using Yammer, one of the products. It’s a dialogue between a few patients, with the doctor (or name your health professional) chiming in.

What do you think? Could this paradigm move patient-physician communication to patient-community-physician communication?

Click on the image to see it larger

Yammer Dialogue


v. neat concept. if one can take into account hippa rules, it could be v. helpful to patients. of course, the physician's legal team may not be too thrilled about it but wording could be put in place about liability and such. come to think of it, this could work in a variety of situations, not just patients and physicians. zappos is already trying something similar to communicate w/n the company. but bringing twitter to healthcare would definitely be v. positive for patients. so do doctors have the time and do patients know the technology????


Thanks for the endorsement of the idea! All things you mention would need to be worked out, of course, but if this is a physician that is already engaged in many 1:1 contacts with patients over e-mail, this might be time saving, and from extension of my PHR work to date, there's always more time to prevent a heart attack than to put someone in the hospital for one.

I posted a slide about the relative growth of Twitter versus on this presentation that I made on Monday – 421% growth versus 50% growth. Both impressive considering that is a patient portal, but clearly patients are knowing this technology pretty quickly.

Now who can we get to try this,


Multiple-user communication is potentially beneficial, and could be embedded within secure messaging. There could be value with folks attending group visits (and signed confidentiality agreements), or those in a structured, serial educational offering – e.g., nutrition or tobacco counseling. But is there added value beyond a traditional e-group? Studies of interactive, tailored interventions (Gustafson DH or Glasgow RE et al) sugggest social networking functions increase the usage of the web-based tools. Big challenge, of course, is competing for health professional bandwith. So perhaps the highest value might be a care manager offering this to his/her panel – with or without their moderation.

Susan Woods, MD

OHSU & Portland VA

I think this is a very interesting idea – particularly for chronic condition self-management promotion. It can be used a tool to enhance communication of virtual groups and potentially increase effectiveness. As an overall concept, the proper design and leverage of such interventions can reduce delivery system costs and allow far greater scalability of self-management promotion.

Is the Stanford/Lorig group also exploring the use of such tools in their evolution of peer self-management models?

Hi Joe and Sue,

So I see this piques your interest, with good use cases coming from both of you.

I don't know what the Lorig group is working on and if they've looked at using ambient awareness applications. If you are out there, Stanford/Lorig, feel free to add your comments,


I'm not opposed to the idea but I'm groping for uses.

What medical situations are tweetable? Example: 140 characters would allow only a tiny fraction of ACOR messages.

What conditions might I have that would make me want to tweet with my patient peers who have the same doctor (or group)?

What's the difference between this and a forum? (I know this is instant, but so is a forum, if you refresh frequently.)

More thoughts – patients sharing ideas/thoughts on each other's conditions and treatment in a setting presumably controlled by the physician. Is the physician then responsible for monitoring everything that goes on?(liability?) And therefore responsible for any misinformation shared? If the group gets large and active, one or even a group of physicians would have difficulty monitoring the entire conversation. What about private messages between patients? Are those also, if done within a providers 'twitter' group, subject to monitoring?

I agree with Susan, the potential is great if you can get the time from the physicians – which means it will likely need to be billable (in steps Kaiser). Perhaps having set times where the service will be 'on' and the physician can be there? But then it's more like a group chat.


It might be interesting to create analogies to how we use Twitter and e-mail today. For example, a doctor with a panel of 1,800-3,000 patients, a group of them will want in person consults, a group will need telephone, a group will need e-mail, a group will need something short of that, and the "short of that" might be a question that could be answered by a fellow patient. One example is a new, common medication start. If a few tweets between patients saves a direct e-mail, that might create expediency and satisfaction – "I have a great physician and I am on a great patient panel."

So as Jason says, this should happen in a way that extends the physician's reach without extending their resources. Does that make sense? And thanks for playing this out a little bit,


Presently, there are bottlenecks with patient doctor communications. Adding a channel that requires (for better or worst) concise messaging will limit its use case but also enable the power of the mobility and ubiquity of mobile phones.

As patients become more savvy about these possibilities my guess is they will find constructive ways to use them.

Excellent idea Ted, there's definitely potential either being for non-official communication (people from the same patient group staying in contact – replaces/adds to the current ideas of forums) or for more official communication when communicating with your phyisician or nurse.

One great example I know using such communication is the Digital IVF polyclinic at the University Medical Center Nijmegen. This initiative is effectively a PHR with additional features such as chat for couples engaged in IVF treatment. @woutertuil just did his PhD thesis on the project (and measuring engagement, participation etc.) You can view his PhD presentation at… and I'm sure he's willing to explain/share more if you contact him.

Keep the provoking thoughts and interesting ideas coming. Love reading them 🙂

I tried using Yammer but it seems that it is only geared toward the work place. I found this site that let me create a network between a couple of us moms in california. We set it to private and now we have our own little hub that we communicate with. I suppose it could work with a Patient-Community-Physician model, but wouldnt that give away privacy?

What do you guys think?

I think these types of interfaces are absolutely essential. Physicians must be especially conscious of privacy concerns and how information is disseminated over platforms like Twitter/ Facebook/ LinkedIN ….

Ted Eytan, MD