Bart J Brandenburg*, Medicinfo Tilburg and IBR Centre for E-health Reasearch and Disease Management Twente University, Netherlands, Tilburg, Netherlands Erik Jansen*, Primary Care Practice ‘t Gasthuis, Gemert and Radboud University Nijmegen Medical Centre, Primary Care Department, The Netherlands, Gemert, Netherlands Track: Practice Presentation Topic: Consumer empowerment, patient-physician relationship, and sociotechnical issues Presentation Type: DEMO Interactive Session Submission Type: Single Presentation Building: LKSC Conference Center Stanford Room: DEMO Interactive Session Upper Lobby Date: 2011-09-17 12:53 PM – 01:08 PM Last modified: 2011-08-12

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In 2009 we, two Dutch physicians assisted by a communication and IT specialist, started a primary care consultation service on Twitter, called @tweetspreekuur. The free service consist of an account where Twitter users can ask health related questions (24/7). Answers are given within 24 hours by primary care physicians, sometimes after consultation of a medical specialist in our network. We reported our first year results at the Medicine 2.0 Maastricht conference and were pleased and honored with the Medicine 2.0 Maastricht Award. Our analysis of 132 direct message episodes (1148 tweets, categorized according to the International Classification of Primary Care (ICPC)) showed that the @tweetspreekuur service covers all areas of primary health care as every ICPC category is represented. It is time efficient and great fun to do. A questionnaire, with recruitment via Twitter, showed good user satisfaction amongst the 122 respondents. Even though gradually growing, Twitter consults are still relatively insignificant in quantity. Our account is followed by less than 1% of Twitter users in the Netherlands. It is the significance of the health problems presented to us and the positive reactions from users and colleagues however, that encourage us to go on. Our two leading concepts: “The Proof of the Pudding is in the Eating” and “Learning by Doing” gave our project a flying start. We realize that now the time has come to contemplate the next steps and address topics such as legal aspects, patient safety and sustainability of the service. We will present our exploration of a few of the next possible steps that (primary care) “social physicians” can take while delivering health services through social media. For instance, expanding our service to other social media such as Youtube and Facebook (or the Dutch equivalent Hyves), where large health and health care related communities exist. Comparing our social media practice with the legal e-consultation guidelines of the Royal Dutch Medical Association demonstrates where theory and practice differ but also shows that transparency and accountability are an important part of the solution. Once again comparing our results, including a content analysis of our second year, with ongoing research in the field of e-consultation (Nijland et al) and telephone consultation (Derkx et al) as well as with data from the Netherlands Information Network of General Practice (the LINH database) helps to define the place of social media within the spectrum of 21st century health care services. With the aid of a holistic framework for sustainable e-health technologies (Nijland, 2011) we will check the sustainability of our health innovation. Last but not least: our 2010 questionnaire taught us a lot about the characteristics of our clientele. Some memorable Twitter consults sparked our curiosity to find out more. We will present a few video vignettes of the remarkable social media pioneers that have entrusted their health problems to us. Bart Brandenburg, M.D. Medicinfo Tilburg and IBR Centre for E-health Research and Disease Management, University of Twente, Enschede, The Netherlands Erik Jansen, M.D. Primary Care Practice ‘t Gasthuis, Gemert and Radboud University Nijmegen Medical Centre, Primary Care Department, The Netherlands