When the new H1N1 flu virus appeared in the U.S. earlier this year, social networking and social media played a significant role in the early distribution of information about its transmission, known cases and prevention strategies.
By Friday, April 24, it was apparent from news reports, blog posts and Twitter updates that the number of cases was growing. The concern of CDC officials was evident. As a paramedic, I began looking on Saturday morning for information targeted to EMS, but all the early information was for hospitals and public health. It was not until Monday that I began to get EMS-specific information from my state office and organizations like NAEMT and NAEMSE. Much to my disappointment, most of that information was just redistribution of the CDC's earlier releases. It took a while longer for EMS-specific guidelines and recommendations to come out. On Sunday, April 26, the EMS Chiefs of Canada had a conference call and released "best practice" recommendations that I learned of on Tuesday, April 28. That same day, four days after the initial news broke, I was also alerted to flu guidelines and resources from the National EMS Management Association.
For me, the most rapid and reliable information about H1N1 came from the CDC's Twitter accounts (@CDCFlu and @CDCemergency). With short headlines and links to more details, I found the information I needed to put the developing situation into context. Had H1N1 been a faster-spreading pandemic with more lethal consequences (and it may still develop into a significant public health emergency), I fear our regional, state and national EMS organizations, governmental and nongovernmental, would not have been prepared to rapidly communicate best practices and just-in-time knowledge through social networks with social media tools.
This article offers an introduction to social networking and social media, how EMS can use them, an introduction to social networking tools, suggestions on best practices and five immediate social networking actions you should take.
SOCIAL MEDIA AND SOCIAL NETWORKING
The terms social media and social networking are often used interchangeably. To me, social media is content creation and distribution, while social networking is the effort to build and maintain relationships with others exposed to your content.
Many EMS providers already use social media tools like MySpace, Facebook and YouTube for creating, posting, sharing and accessing personal images, videos, music, audio recordings, e-mail and other content. The ability to create, post and share content is a foundational component of many social networking sites. The various types of social media can bring different benefits to EMS organizations.
Videos captured with small handheld camcorders, digital cameras or smartphones and posted to YouTube are social media. They represent content, created, captured and posted with minimal planning and work. YouTube also has components of social networking: A user can create a YouTube channel, invite and accept subscribers to it, and interact with viewers and subscribers who leave text and video comments. For example, in July 2008 I filmed a Combitube insertion and posted the video to YouTube. That video has since been viewed more than 14,000 times. Since posting the content I have received and responded to comments from video viewers. The effort of those interactions is social networking.
EMS agencies can use video to:
- Demonstrate things like airway management skills for annual refresher training;
- Showcase new ambulance features for general public viewing on organization blog;
- Interview successfully treated patients like cardiac arrest survivors for recognition events and public viewing.
A podcast is an audio or video program optimized for delivery and listening on a smartphone, MP3 player or computer. Audio content can be easily captured and edited with free software tools like Skype, CallBurner, Google Voice and Sound Forge, then published to a website or blog. Through an RSS feed, podcast content can be automated for delivery through services like iTunes. MedicCast.com and EMSGarage.com are two popular and widely distributed podcasts. Audio recordings can also be distributed to private audiences using a learning management system or intranet.
EMS agencies can use podcasts to:
- Record interviews with experts like their EMS medical director on specific patient care issues;
- Record morbidity and mortality patient case reviews;
- Record lectures by CE speakers and presenters.
Blog is short for web log. A blog is a dynamic, regularly updated portion of a website, or a website unto itself, used to communicate news and opinions in an immediate, daily way. Using "what you see is what you get" content-editing systems, bloggers can quickly add new posts to blogs and new pages to blog websites without needing to know complex design code.
EMS agencies can use blogs to:
- Announce news and events;
- Provide timely and seasonal injury-prevention tips;
- Distribute links to additional information for things like common diseases, injury and illness prevention, and whatever else people need to know.
Twitter is a common and widely known microblogging tool that allows users to post messages of 140 characters or fewer. Twitter social media & networkings allow users to follow and read the posts (Tweets) of other users, reply to them and forward them to other users. One of the first photos of U.S. Airways Flight 1549 after its emergency landing in the Hudson River in January was posted by Twitter user Janis Krums. Krums Tweeted, "There's a plane in the Hudson. I'm on the ferry going to pick up the people. Crazy."1 Krums' Tweet was accompanied by a link to a photo captured with his smartphone (see http://twitpic.com/135xa).
EMS organizations can use microblogging to:
- Link to new blog, podcast and video content;
- Rapidly share information during a major incident or crisis;
- Develop a network of followers to more widely distribute content.
Creating social media content is relatively easy. Connecting with the right people who share your interests or would benefit from your content is the true challenge. A proactive strategy to build relationships is needed if you want to use social networks for mass notification during a pandemic or disaster. There are a lot of methods to build a network; you may benefit from employing several.
Social networking sites, such as Facebook, LinkedIn and EMS United, are one way to build and maintain relationships. LinkedIn is primarily for job-related networking. An EMS manager could use it to connect with other EMS managers, share resources, join groups focused on EMS management, or recruit job applicants. Users' LinkedIn profiles contain fields for work history, education and other interests.
Facebook has grown exponentially in the past 12 months. It now has more than 250 million registered users, and almost half of them log in at least once a day (www.facebook.com/press/info.php?statistics). If you're not already on Facebook, many of your employees, vendors, competitors and patients likely are. Most Facebook users are out of college, and the fastest-growing user demographic is over 35 years old.
EMSUnited.com is an EMS-specific social networking site powered on the Ning platform. Ning sites are "for people to join and create new social networks for their interests and passions and meet new people around the things they care about."2 At EMS United, users can connect with other EMS professionals, join groups, share photos and videos, write blog posts, and start and contribute to forum discussions. Members can join more than 100 special interest groups, such as the Arkansas EMT Association, KapStone Rescue Squad or E-Learning for EMS, or start their own.
An EMS organization could use a private Facebook or Ning group like an intranet to deliver information to its members, share news and updates, ask personnel for feedback or direct members to visit websites with continuing education content.
Blogs and microblogs, while used to create and share content, also have a social networking component. Many bloggers make an effort to build relationships with their readers by encouraging and responding to reader comments. For example, the blogger Your Happy Medic (http://yourhappymedic.blogspot.com) frequently poses questions in his posts that encourage readers to interact with him and one another.
SOCIAL NETWORKING USES
How an EMS organization can use social networks is limited only by its time and goals. EMS managers frequently need to distribute information like staffing and equipment changes or maintenance or training dates and locations to personnel. In addition to bulletin board postings, letters and e-mails, those announcements could be posted to a Facebook or Ning group.
Social media like videos and podcasts can be created for training and distributed using social networking channels. You can use a simple digital audio recorder, for instance, to capture audio during updates from your medical director, then post it on your organization's social networking site. Use a digital camera to capture the proper use of a slider board and post it to the employee blog. Embed a YouTube video that demonstrates an airway management procedure into your organization's Facebook page. Link to and comment on EMSResponder.com articles on your blog.
EMS organizations are likely to have expanding roles in illness and injury prevention in their communities. Leaders can create and distribute content to share information and resources on topics like stroke signs and symptoms, child passenger seat safety and proper use of sports safety equipment. Instead of a static website for your organization, use a blog to regularly add CDC injury prevention updates, links to child safety resources, and examples of your department's injury-prevention activities.
Growing a community of people who want to connect with your organization could prove invaluable during a major incident. Social networking can be used for mass notifications on topics like:
- Evacuation routes away from a hurricane's projected landfall;
- Locations of shelters for citizens fleeing wildfires;
- Shelter-in-place instructions for outbreaks like H1N1;
- Contact numbers for friends and families of victims of major incidents like train derailments.
The public information officer, an integral member of the incident command staff, distributes information to the media during significant incidents. A PIO who is knowledgeable about social media tools and social networking could rapidly deploy messages directly to interested parties, patient-receiving facilities and media. For example, during a passenger train collision and derailment, a social media PIO (SMPIO) using a smartphone and Twitter account could provide quick bursts of information about:
- Anticipated numbers of casualties;
- Their potential severity;
- Alternative routes for commuters;
- Agencies responding;
- Patient transport initiation and conclusion times;
- Times and locations of press briefings;
- Contact phone numbers for concerned friends and family;
- Images of the incident, responders and rescue actions in progress.
To use social networking effectively for mass notifications during a large incident, an SMPIO needs to be familiar with social media content creation, establish a social networking presence, regularly distribute content to develop an audience and establish expertise, and develop relationships with key constituencies like local media, government leaders, bloggers and interested citizens.
Remember, every incident now has victims, bystanders and, in all probability, some of your own personnel acting as unofficial social media PIOs. In any major incident, multiple people will be Tweeting, blogging and uploading images and videos to social networking sites. Command needs to assign an official SMPIO to communicate on social networks to an audience they've worked to build.
Every EMS organization needs a social networking and media policy. It would be naive to forbid employees from using social networking sites or creating social media content while on duty. Since many EMS providers have downtime, it is prudent to guide them on appropriate social networking and media practices. Your policy should cover:
- When and where it is appropriate to create social media content and participate in social networking sites while on duty;
- What type of content can be shared.
A policy should also describe your organization's official social networking presence. If you don't establish an official presence, employees will likely create unofficial/unauthorized groups, pages and accounts.
Blogger Jeff Levy recommends this social media policy for government agencies and their personnel:3
- DO: Use social media tools to serve your mission.
- DON'T: Be stupid.
Support these general guidelines with examples to help personnel understand how to appropriately use social media and social networking to communicate on and off the job.
Another important aspect of participation is building connections. Accept friend and follower requests, seek out others who share your interests, and interact regularly with your friends and followers. You never know which fan might be an on-scene observer who can relay lifesaving information during an incident, or which friend might be able to re-Tweet your injury-prevention message, exponentially increasing its impact.
An EMS Social Media Case Study
The EMSEdUCast (http://emseducast.com) is a podcast by and for EMS educators. Its team of cohosts has used social networking to grow their podcast's audience to more than 3,000 weekly downloads in just 20 weekly episodes. The networking effort included announcing the podcast on other podcasts, sending out Tweets during each episode's recording, posting the RSS feed, listing the podcast at iTunes, writing blog posts about the show, and announcing new episodes on EMS social networks. It was not until we'd done 20 episodes that we generated a formal press release about the podcast.
Starting a blog is easy. Ask your website designer about integrating a blog into your organization's website. If that's not possible, start one using Blogger, WordPress or TypePad. But remember, starting the blog is the easy part. Regularly adding content and recruiting readers is the difficult aspect. Plan to add content on a regular basis.
Once your organization begins to create social media content and participate in social networking, participate! If you want your Twitter account or blog to be a trusted source of information, update it on a regular schedule to show you want to engage with users and make contributions. If your blog languishes for weeks at a time without updated content, it will not be a trusted information source sought during a major incident.
RSS Feeds and E-mail Subscriptions
Notifying people of new content added to your website is a critical social networking strategy. The first step is to make sure your organization's blog/website has an RSS feed and allows visitors to subscribe to receive content updates from it. FeedBurner and FeedBlitz are two free and easy-to-use RSS notification services.
RSS stands for really simple syndication. An RSS feed allows users to subscribe to a website's feed and have new content on that site automatically loaded into an RSS feed reader or subscription device like an MP3 player. You can also use a feed aggregator like paramedic.alltop.com to look for updates to multiple blogs at once, or build your own page of favorite RSS feeds at my.alltop.com.
The next step is to build an e-mail subscriber list. Cultivating e-mail subscriptions is a common social networking effort for online retailers and news and information websites. For example, each Friday I receive an e-mail from EMSResponder.com that social media & networkings news and headlines from the website, as well as advertising. Capturing e-mail addresses of website visitors, employees, local media and other stakeholders gives you an opportunity to create content--like a regular e-newsletter--and distribute it to subscribers. Services like AWeber and MailChimp invite website visitors to become e-mail subscribers, and can automatically distribute e-mails to them.
These are five things to do now:
Develop an organization social networking policy that includes guidance on:
a. Usage during work hours;
b. Content that can and can't be shared/posted;
c. Official social networking presence.
Learn more about social media and networking:
a. Attend my presentation at EMS EXPO;
b. Visit PIOsocialmediatraining.com for a free social media training program for PIOs and IC staff.
Join at least one of these social networks (and add me as a friend if you like):
c. EMS United.
Participate in a social network:
a. Add social media content (photos or video) to your profile;
b. Join and contribute to a group or groups;
c. Post a news item about your organization or personnel.
Monitor social networks for mentions—good and bad—of your organization. Simple tools for monitoring include:
a. Setting up Google News and Blog alerts;
b. Twitter searching RSS feeds;
c. Looking for and befriending colleagues, media and elected officials.
Continue the conversation, share resources, discuss policies and ask questions about social media and social networking at EMSUnited.com/elearningforems.
Social Media Training for PIOs
Through the power of social media, individuals, small businesses, large corporations and government agencies all have an equal opportunity to have their messages heard. The mission of www.PIOsocialmediatraining.com is to empower emergency response agencies to effectively create social media to achieve their goals. Visit the site to enroll in the free e-mail "boot camp" training program.
Greg Friese, MS, NREMT-P, is the director of education for CentreLearn Solutions, LLC. He specializes in the development, production and distribution of online education for emergency responders. Greg is a leading advocate for the use of social media by EMS agencies and training organizations. Greg is a regular conference presenter, the co-host of the EMSEduCast, the founder of the EverydayEMSTips.com blog, marathon runner, and participant in many online EMS communities.