How to Tweet a Surgery in Real Time


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How do you live tweet a surgery? Better yet, how do you do it at one of the most prestigious university medical centers in the country? Ryan Squire is here to tell us how. And perhaps even more interesting is how Ryan has made social media mainstream at the Ohio State University Medical Center.

Twee Surgery

Ryan Squire is the Program Director for social media at the Ohio State University Medical Center. Ryan joined the staff at the Ohio State University Medical Center in May 2009 and is responsible for the overall strategic direction and continuous development of the social media program that includes empowering all 16,000+ employees to use social media. At the Ohio State University Medical Center, Ryan is building a culture of engagement by creating policy, teaching the social media tools, advising departments on their use of social media, and formed an advisory board to monitor and respond to emerging technologies and trends.

Interview Highlights with Ryan Squire

  • Ryan’s 3 primary goals as the Program Director for social media at the Ohio State University Medical Center.
  • How Ryan was able to make social media mainstream within the culture at the Ohio State University Medical Center.  Hint: start with the executive leadership.
  • Ryan’s 2 main goals of the recent live-tweeting and Ustreaming of the MAKOplasty surgery at the OSU Medical Center.
  • The biggest obstacles Ryan faced through the coordination of this event.
  • The 4 procedural steps Ryan used to put together the live-tweeting and Ustreaming of the MAKOplasty procedure.
  • Lessons learned through this process and what Ryan would do differently.
  • Ryan’s response to the statement, “social media is a fad and a waste of time”.
  • And much, much more!

This Is What You Can Do Next

1) You can listen to the interview with Ryan Squire right now:

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4) Read the following transcripts from my interview with Ryan Squire.  Also, feel free to download the transcripts by clicking here.

Read the Interview with Ryan Squire

Scott Nelson:    Hey everyone, it’s Scott Nelson. Just a few quick messages before we get started. First, as a reminder, Medsider is on iTunes. Just do an iTunes search for Medsider and you can subscribe to the podcast for free. That way, all the new interviews will automatically download to your iTunes account. It’s super-easy. Also, if you like the podcast, don’t forget to rate it. That really helps us out. A couple of other ways you could follow Medsider, subscribe to our email newsletter, like us on Facebook or join our LinkedIn group.

                           Second, since 2005 my friend Ryan Gray has been helping thousands of medical sales professionals keep an edge on the competition. He gathered a team of sales managers and top sales reps to discover the best ideas and practices that drive more business and yield the most commissions. Their findings are highlighted in the number one medical sales book of all time, the Medical Sales Desk Reference. You can find the Medical Sales Desk Reference at Amazon.com or go to Ryan’s website at Vendesigroup.com. That’s V-E-N-D-E-S-I-G-R-O-U-P dot com. And here’s your program.

Hello everyone, it’s Scott Nelson and welcome to Medsider, home for ambitious medical device upstarts. This is a program where I interview dynamic people that are doing interesting things in the med tech and medical device arenas. The primary goal is that we can all learn a few things, and hopefully there’s some entertainment value along the way.

So our guest on the program today is Ryan Squire. He is the Social Media Program Director at The Ohio State University Medical Center in Columbus, Ohio. There are a couple of things that I’d like to accomplish on this interview. One is that we’ll learn a little bit more about what Ryan does as the Social Media Program Director, what kind of his day-to-day life looks like, but we’re going to spend most of our time in this interview focusing on something very interesting that Ryan helped coordinate recently in that the Ohio State Medical Center live tweeted and ustreamed a surgery. And so we’re going to dig into that, learn a few things, learn more about Ryan’s big takeaways from that event, so it should be an interesting conversation. So without further ado, welcome to the call, Ryan.

Ryan Squire:    Thanks, Scott. Thank you very much.

Scott Nelson:    So first give the audience kind of a general overview of what your role is as the Social Media Program Director at Ohio State.

Ryan Squire:    Okay. Well, at Ohio State I’m responsible for our overall strategic direction and then implementation of pretty much everything social that we do from a corporate standpoint. So that includes all of our hospitals, our medical school, our Comprehensive Cancer Center, and pretty much all of our properties in the medical center. And so I think initially the idea was, two years ago when I started some of the idea around social media, what can we do around campaigns as far as campaigns for certain product lines or to let people know more about what it is that we do. But what I’m really interested in and really what I focused in on over the last two years has been our high-level strategic goals, and then what I can do with social media tools to help reach those goals, so really, more of our business and our business goals.

And I think what I’ve found, we have three strategic goals. The first one is to be a top 20 academic medical center, and a big way that we do that is to work on our national reputation. Being in Columbus, Ohio, we’re kind of at a disadvantage at times because we’re not in the health belt, we’re not on the East Coast or the West Coast, and a lot of people don’t understand that being a part of the Ohio State University is a huge benefit for us. I mean, just the scope of research that we can do on one campus is unparalleled in the country, and that’s really helped benefit our medical research because we can draw from engineering and business and other health sciences, and it all happens in a couple of square miles in the middle of Columbus, Ohio.

Scott Nelson:    Sure.

Ryan Squire:    So trying to capture that and help raise awareness about what it is that we’re doing in a lot of different areas around research and those kinds of things is one of our strategic goals. The next one is to be a workplace of choice and a place of innovation, and that’s important because in the next four years we’re going to finish a 20-story cancer hospital. We have a dedicated cancer hospital now, but it isn’t big enough and we don’t have enough beds. And so we need to be a workplace of choice because we want to hire talented people who want to come to work at Ohio State.

Scott Nelson:    Mm-hmm.

Ryan Squire:    And I’ll talk a little bit about how we reach that goal in a second. And then the third is to be raise enough money to support our mission. I mean, being a not-for-profit hospital and a public institution on top of that, we have to be able to support what it is we want to do.

Scott Nelson:    Sure.

Ryan Squire:    And so fundraising is a big part of that.

Scott Nelson:    Okay.

Ryan Squire:    So what I’ve really focused on last—I mean, of course, we have to have Facebook presence and we have to have a Twitter presence and YouTube presence, but it’s more about creating content and using social media, which in my definition is very different than Facebook and Twitter and YouTube, right? I think social media—Brian Solis likes to say that social media is the democratization of information and a shift from people as being just content readers to content publishers, and I think those two things are very important to understand in healthcare…

Scott Nelson:    Okay.

Ryan Squire:    …because it’s very different than the way we’ve done business traditionally, right?

Scott Nelson:    Mm-hmm.

Ryan Squire:    You know, traditionally, health information isn’t democratized. It’s whatever the doctor or nurse says it is. This is what’s wrong with you. And so with the rise of ePatients and people who are empowered and they have tools to go online and to look and see what they’re experiencing, what other people have experienced that’s similar, there’s no more “one way is the only way.” And so there are lots of examples of patients who have gone out and diagnosed their own illness, and in some ways, even been able to ask for and receive treatment based on what they’ve been able to find.

Scott Nelson:    Sure.

Ryan Squire:    That’s how social media and the web is influencing medicine. So that’s an important paradigm, this idea that information is democratized. The next one, the shift from people as readers to publishers, is important, especially when we look at like in our customer service area. I mean, no longer does a patient have to just be a patient where we practice medicine on them. At Ohio State, we’re very focused on getting patients to participate in the experience. It’s one of the four P’s that we talk about. And so that participatory medicine is extremely important. And we can use social tools to do that, right?

Scott Nelson:    Mm-hmm.

Ryan Squire:    I mean, now, instead of sending a survey and finding out that a patient had a bad experience two weeks after they had the bad experience, we can find out in real time and change it in real time, and we’ve done that. And so customer service is obviously one of those places where we want to predict issues that might come up, prevent them from ever happening and help participate with the patient to have a better experience.

Scott Nelson:    Mm-hmm.

Ryan Squire:    And so that’s one of the ways that we use social media. So that’s just kind of a quick overview. There are other things too, right?

Scott Nelson:    Sure.

Ryan Squire:    Business [00:07:45] looking at development and fundraising.

Scott Nelson:    Okay.

Ryan Squire:    You know, university-wide we’re in a program right now that’s taking us from the development alumni relations, communications and marketing model to an overall advancement model. This has happened in a couple—I know University of Washington has done this. So an advancement department includes all of those areas. It’s alumni, communications marketing and development working together, working in harmony. Well, at the medical center, you know, I think we want to add one more. I think we want to add patient experience or customer relations to that. And then we have the right people at the table to ensure that we’re reaching as many people as possible to help us support our mission.

Scott Nelson:    Okay.

Ryan Squire:    And then, using digital tools and using social technology online to ask people in different ways, to reach more people, to ask them for—you know, the Barack Obama model of funding, right?

Scott Nelson:    Mm-hmm.

Ryan Squire:    I mean, he didn’t go out and fund his campaign with 2000-dollar dinner plates. He asked for 5 dollars and an emotional connection to change, right?

Scott Nelson:    Uh-huh.

Ryan Squire:    Well, we have lots of emotional connections in our hospitals. I mean, we’re curing people’s cancer. We’re saving them from heart attacks. We’re doing lots of things that have emotional connections. We’re just not doing enough yet to ask people the right time in the right place for those donations. And so I think that we can do more with social media to help understand those right time, right place situations and ask. And then, from the national reputation thing, that’s where we start to get into what we had talked about as far as the surgery.

Scott Nelson:    Sure. Okay.

Ryan Squire:    I think those are some—recruitment obviously is another one that’s big. I mean, we want to hire the biggest and brightest people. You know, I talked a little bit about workplace of choice. That’s one of the reasons why the first thing that I worked on when I got there was a policy that said that our employees can use social media.

Scott Nelson:    Mm-hmm.

Ryan Squire:    I think if you’re a company right now and you have an intent of hiring anybody under the age of 30, and especially under the age of 25, and obviously each year that gets a little older, and you don’t give them access to tools that they use to stay connected to their world, you’re going to have a difficult time helping them feel comfortable in the workplace.

Scott Nelson:    Sure.

Ryan Squire:    I think they’re going to expect access to this stuff, and if you’re taking away access it’s just unnatural because everywhere else they have it, right? Or they can pull their phone out.

Scott Nelson:    Right.

Ryan Squire:    And you lose the opportunity to talk to them, too, in a place where they’re comfortable having conversations and those kinds of things. So we’re very interested in keeping access open and…

Scott Nelson:    Sure.

Ryan Squire:    …allowing people to be adults, empowering them with these tools and with some understanding around what they can do in terms of medicine and healthcare, and then asking them to do incredible things and seeing what the results are. I think there’s a lot of management theory there that we’ve worked on and that we’ve dealt with, but I think the bottom line is respecting people enough and knowing that you’ve hired the right people, and then coaching them if there are issues.

Scott Nelson:    Sure.

Ryan Squire:    But otherwise, giving them space to figure out and use these tools to do something incredible.

Scott Nelson:    Yup, yup. And listening to you just there, obviously it’s very evident that you’re very well-spoken in regard to this whole social media arena. But what I find really interesting, and I don’t want to spend a ton of time on this but…

Ryan Squire:    Yes.

Scott Nelson:    …what I find really interesting is that it seems that your goals are very much aligned with the goals of Ohio State in terms of integrating their kind of, I guess, mainstream goals with social media. And the reason I ask is because it appears that you’ve been able to get them most of the people on board, which I have to think, one, had to be very hard, and two, probably isn’t very common in most institutions.

Ryan Squire:    So I think obviously there’s a strategy there, Scott…

Scott Nelson:    Mm-hmm.

Ryan Squire:    …but the idea is, instead of going out and creating my own goals, setting my own sights, I mean I have lots of ideas of things I want to do, right?

Scott Nelson:    Mm-hmm.

Ryan Squire:    But instead of going out and saying, “Okay, these are all the things that I want to do,” instead we went out and said, “Okay, here are all the things that we need to be doing to be helping our senior leaders accomplish the goals that they’re held accountable for, right?

Scott Nelson:    Mm-hmm.

Ryan Squire:    I mean, on their performance evaluations they’re being asked that they increase national reputation, that they create a workplace of choice, that they raise money, and so if I can make those the goals and I can do something to affect those and impact those goals for them, it’s going to make it very easy for me to—I didn’t even really have to sell this stuff, right?

Scott Nelson:    Yeah.

Ryan Squire:    I mean, here’s what we can do, here’s what I believe we can do, let’s test it. Well, if I’m wasting time just talking about ourselves or doing something that doesn’t roll into something that’s important to them, then yeah, then they’re going to want to know, “Okay, what’s the ROI?” and start asking some of these [00:13:25] questions. But they’ve really given me plenty of autonomy to figure this out, right? And figure it out in terms of what’s important to them already. And I think that’s where a lot of times I think people make mistakes, is they forget. You know, your institution has these higher-level goals, and if they don’t they should, and communications marketing can be pivotal in creating those for an organization and helping the organization understand what those goals are.

But the next step then, I think, in communications and marketing and with communications and marketing teams is to help the organization understand what it is they’re doing that falls in line with those goals, because that determines your brand, and then what they’re doing that doesn’t fall in line with those goals that you have. And if a strategic communications team, the marketing team, can help an organization understand that, then they have a better chance of actually creating a brand as opposed to just a tagline that’s detached from the reality of what the brand experience is for your customers and for your employees.

And so, honestly, that’s one of the biggest ways that we got by on. I mean, when we first did the whole policy thing, it took a lot of conversation obviously, it took a lot of people at the table. And we didn’t try and backdoor anybody. We didn’t try and surprise anybody with it. Brought everybody into the table upfront and had a conversation and said, “This is what it can do. This is what it can’t do. Here are our limitations. Here’s how it works with HIPAA. Here’s what is a common-sense-type way to go about policy on this.” But it really wasn’t, Scott, until I aligned the policy where that strategic goal of being a workplace of choice…

Scott Nelson:    Mm-hmm.

Ryan Squire:    …that they were able to see, “Wow, yeah. This is something that we have to do.”

Scott Nelson:    You know…[laughs]

Ryan Squire:    “Not something that would be nice to do but something we have to do.”

Scott Nelson:    Right. I never would have thought that that would have been your answer, because I’m envisioning these folks who maybe have used Facebook to a certain degree but really aren’t familiar with Twitter, don’t really use YouTube that much, getting together and thinking, “Oh man, social media, it’s a big waste of time. I can’t have my employees wasting their time on this sort of stuff.” But yeah, you’re saying that basically through being very transparent, being very upfront about the capabilities of social media, and then really aligning that, or I guess not necessarily aligning but showing your colleagues how they can use social media to meet their goals, that really kind of was the trigger.

Ryan Squire:    Right, that was absolutely the trigger, and it started with our senior leadership. I mean, that’s where I went first.

Scott Nelson:    Yup.

Ryan Squire:    And a lot of people like asking and I’ve had the question, “How did you prove the ROI?” Well, you know, our CEO had a video blog, and so he could see the ROI because he could see people interacting with him and asking questions.

Scott Nelson:    Huh, right.

Ryan Squire:    Our VP of Human Resources had a blog that he’d communicate with the people in his staff, just in HR. Lots of comments, lots of questions, lots of conversation. Got to see the ROI.

Scott Nelson:    Gotcha.

Ryan Squire:    And I think doing those things, you know, we created a leadership blog for the Dean of the College of Medicine and then talked about some of the leadership concepts around healthcare reform and accountable care organizations and that kind of thing, so they had a platform to talk about some of these things that were important to them and they got to see that hundreds of people, thousands of people are viewing this stuff and reading it. And so proving the ROI to them, I mean they got to see the ROI of those things.

Scott Nelson:    Sure.

Ryan Squire:    And then when you do additional things, when you do things like a video that helps explain a concept or when you do use Twitter to get a story that’s in a niche science publication brought to the top of their publication as far as views on a certain day, and then publishers or editors from USA Today see that and then put it in their publication, and you can show how that happened just by using these tools to get messages out and links out and looked at, it kind of lights up for them. They really can see it.

Scott Nelson:    Sure.

Ryan Squire:    And so it’s reporting back to them and keeping the conversation going, but yeah, I mean, tying it back to those goals that they have is absolutely essential.

Scott Nelson:    Sure. To your point about ROI, I mean I’ve heard that quite a bit, and I think some people expect you to deliver some sort of metric that, “Since we launched this YouTube campaign we generated X amount of dollars,” or something along those lines, but you’re saying that by just showing basic examples of, “Look, you posted this YouTube video and these are the comments,” or we did this, so basic kind of tangible examples of increased interaction, etc., that’s kind of overcome that ROI issue.

Ryan Squire:    Right. Well, and if that’s your goal, so remember, I mean one of our goals is increasing national reputation.

Scott Nelson:    Yup.

Ryan Squire:    And so placing a story in USA Today would be one metric that we can say helps us reach that, right?

Scott Nelson:    Yup.

Ryan Squire:    The Twitter surgery thing, I found a little write-up in Becker’s Hospital Review, and obviously they’re a big publication, right? And so a national reputation thing. So I can say yes, this helped us achieve another piece of national reputation.

Scott Nelson:    Okay.

Ryan Squire:    And so to produce statistics on ROI, you have to be able to tie it back to your goals, right?

Scott Nelson:    Sure. Yeah.

Ryan Squire:    So we’re doing strategies around development right now and we’ve done a couple of things to do that in that space, and I can come back and I can say we raised X amount of dollars. Maybe that’s not a ton, but we got another 300 people in the pipeline that we can look at and understand what the capacity to get this.

Scott Nelson:    Mm-hmm.

Ryan Squire:    Much more important is understanding the capacity [00:19:50] to give and having more people look at than getting a hundred thousand people to donate 5 dollars.

Scott Nelson:    Sure.

Ryan Squire:    I mean, sure, that’s important too, because we like 500,000 dollars, but now we’ve got all these people to look at, right?

Scott Nelson:    Yeah.

Ryan Squire:    And so those things are very important, of course. Then, the flipside of that is, in communications and marketing, we can look at it and we can say, “Okay, here are people that are engaged and they want to talk about us, and so now we just have to connect them with more information so that they’ll do that.”

Scott Nelson:    Yeah.

Ryan Squire:    But really where it started, Scott, was in customer service. There’s been a big push in healthcare around taking better care of patients and listening to patients and that kind of thing.

Scott Nelson:    Mm-hmm.

Ryan Squire:    And so the first couple of times that we had a patient complain on Twitter or on Facebook and then responded and turned around the situation in real time, and then showed our managers how that happened, of course first they said, “Oh my gosh, they’re saying that on social media,” but we’d already had the conversation about people are going to say negative things if negative things are happening, right?

Scott Nelson:    Uh-huh.

Ryan Squire:    And they understand. These are smart people.

Scott Nelson:    Yeah.

Ryan Squire:    I mean, our CEO has literally written the book on gestational diabetes. He’s been the Dean of the College of Medicine of Vanderbilt. I mean, smart guy, right?

Scott Nelson:    Yeah.

Ryan Squire:    So he understands [00:00:00] what it’s worth, at least some of it, and when you explain it to him he’s not afraid of what people are going to say. He knows people are already saying stuff.

Scott Nelson:    Sure.

Ryan Squire:    What he’s afraid of is how we’re treating people…

Scott Nelson:    Yup.

Ryan Squire:    …and what we’re doing to create good exceptional experiences for people. And so when he sees somebody tweet something about a three-hour wait time and he sees us able to turn that person around and that person later in the day becomes a marketer for us—and this has actually happened—he sees that happen, he’s like, “Well, why aren’t we doing that all the time?”

Scott Nelson:    Yeah.

Ryan Squire:    I mean, we should be doing this all the time. It just makes so much sense. And so there’s not a whole lot of selling that has to happen when you’re able to give people those kinds of examples.

Scott Nelson:    Right, right. There’s a whole host of questions that I could ask you probably for another hour on this sort of topic but…

Ryan Squire:    Yeah. No, it’s fine.

Scott Nelson:    No, that’s really good stuff. At this point, I kind of want to move on to the recent live tweet and video stream of that surgery.

Ryan Squire:    Right. Yeah.

Scott Nelson:    So let’s transition there. What were your main goals in accomplishing this?

Ryan Squire:    So our main goal was to educate people in Central Ohio on this new procedure, because this is the first time that MAKOplasty has been available in Central Ohio.

Scott Nelson:    Okay.

Ryan Squire:    I don’t know if your listeners or your readers know what MAKOplasty is, so just real quick…

Scott Nelson:    Sure.

Ryan Squire:    It’s a surgical alternative to total knee replacement. So if a person has early or middle-stage osteoarthritis, generally speaking they would have had to have a total knee replacement to alleviate the pain. Well, total knee replacement is very invasive, you know, long hospital stay, long physical therapy afterwards, and it just takes a lot of time to be back on their legs. It works, but it takes a lot of time to be back on their legs. The other thing is, if you do a total knee replacement for somebody who’s in their mid-40s, early 50s, even 60s, these things only last for 10, 15 years…

Scott Nelson:    Sure.

Ryan Squire:    …and then it needs to be done again. Well, now people are living longer, so now they have to have two total knee replacements in their lifetime, and that’s just a lot of trauma and a lot of work on the knees. And so what MAKOplasty does is it uses a robotic arm. It’s still a physician doing the surgery but the physician uses a robotic arm, and it kind of works like a dremel tool. So in orthopedics they use lots of saws and that kind of thing, and so the difference is a big blade, or if you’re familiar with the dremel tool, it goes in and it kind of shaves away the diseased part of the bones so that they can put the implants and get people back on their feet. So the goal was to educate both referring physicians and patients on this procedure. At the same time, we wanted to open it up to our medical students. I mean, being an academic medical center, one of the things that’s important to us is education. That’s a big part of our three-part mission, right? Education, research and patient care.

Scott Nelson:    Yeah.

Ryan Squire:    And so in terms of the education mission, we wanted to open that up and show our med students about another procedure and talk through kind of what it looks like. And then there were other goals that we wanted to test and see how it worked. I mean, families sit in waiting rooms when their loved ones are in surgery and best-case scenario they get a board that tells them, you know, preop anesthesia, operating room…

Scott Nelson:    Sure.

Ryan Squire:    …and anesthesia postop and all that, and that’s what they get to see. Well, obviously, this is going inside the surgical room. It’s a whole different level of access.

Scott Nelson:    Yeah.

Ryan Squire:    You can actually see what’s happening and ask questions based on what you’re seeing. And that’s something that families have never been able to have before but it’s essential, and I can describe the next day why it was so powerful for Tom and his family.

Scott Nelson:    Yeah.

Ryan Squire:    But those are kind of goals. Obviously, from a communications and marketing standpoint, there’s a goal of raising awareness about it, a new surgery or a new thing that we’re doing, but it talks about national reputation and it talks a little bit from the social media side. I had done some research and knew that we would be the first in the State of Ohio to live tweet a surgery.

Scott Nelson:    Mm-hmm.

Ryan Squire:    We’ve video broadcasted surgeries before for like CME but never on Ustream and never live tweeted, so this is certainly a first for that. So all those things were kind of in the plan, but the main goal was the education around it.

Scott Nelson:    Sure. Okay. Very cool. And so when you first brought this idea to the table and you were beginning to coordinate it amongst the physicians, the staff, the administrators, etc., even at the patient level, what was the initial response? Were there some big drawbacks or big obstacles that you had to overcome in kind of coordinating…?

Ryan Squire:    You know, I think part of it, Scott, is over the last few years we’ve created a culture that understands and accepts social media and looks for new ways to use it, to deliver on some of our goals, and we already have, right? I mean, I’ve gone through that thoroughly already.

Scott Nelson:    Sure. Yup.

Ryan Squire:    So it just kind of seems like a fit. I mean, here’s a new procedure. We want to let people know about it. Actually, the first conversation we had, Steven, the person who was in charge of orthopedics for us and communications marketing, came to me and said, “Hey, I think this might be a great opportunity for us to do it.” And actually, the first time that we looked at doing it was going to be the first MAKO surgery that we did about a month and a half ago, two months ago, and we actually said, “Oh no, let’s wait,” because we weren’t quite ready yet. We only had about two weeks and we hadn’t gone through everything that we needed to go through.

We hadn’t talked to our legal department and our lawyers to make them comfortable and aware. We hadn’t put together a plan in case there was an emergency. We hadn’t really sat down physicians and talked them through the kinds of things that we were going to be saying and what people would see, and we really hadn’t had a chance to sit down with the patient and explain to him, “Here’s what you can expect and here’s what people see. And do you have any special request?” And all those things were very, very important to us and things that over the next month and a half, in preparation for the next surgery, we did.

Scott Nelson:    Sure.

Ryan Squire:    And finding the right patient is important too. Finding the right surgeon is important, because not all surgeons are going to be open to this and okay with it, and if they’re not comfortable, you don’t want that, right?

Scott Nelson:    Mm-hmm.

Ryan Squire:    I mean, you don’t want to make a physician uncomfortable with the camera in the operating room. [Laughs]

Scott Nelson:    Yup.

Ryan Squire:    That would be detrimental to what we’re doing to take care of patients. And so it was very important to have the surgeon involved and comfortable with this. And we actually had two of them.

Scott Nelson:    Mm-hmm.

Ryan Squire:    So I’ll talk a little bit about that in a second. So those were the things that we did. We first put together a statement of purpose because I wanted to be very clear that we weren’t doing this for marketing reasons, right?

Scott Nelson:    Okay.

Ryan Squire:    This wasn’t a PR stunt. Because the minute that this becomes a PR stunt and something goes back, then you haven’t reached your goal, right?

Scott Nelson:    Mm-hmm. Yup.

Ryan Squire:    But if our goal was to say and show people how cool we are in how we can tweet a live tweeted surgery, then if something went bad and we stopped because we didn’t want to look bad, then we didn’t fulfill our goal.

Scott Nelson:    Yup.

Ryan Squire:    If instead our goal was to educate people and something went wrong, well, that’s part of medicine. That’s part of science, part of doing business. And so we had put together a plan that we’d stop the live camera out of respect for the patient, but we would continue to tweet and talk about was happening and update people on the status of the patient and what they were doing to alleviate the emergency situation. And so, am I glad that that didn’t happen? Yes. But if our goal was to create positive PR and then something wrong, we wouldn’t have been able to reach our goal. Our goal is to educate. And that’s why it was so important to frame it that way for us, so that we really understood it.

                           So we put together a statement of purpose and we put together these emergency plans. We talked to the physicians. We consented the patient, obviously, explained to him what was going to happen and got a HIPAA consent, which is something our media relations team takes care of, and then we were good to go.

 Scott Nelson:   Okay.

Ryan Squire:    And got a little bit of a history from the patient and what they did, what Tom did and what his situation was, and so we were able to kind of set the scene for people. And bought a 50-dollar cord to hook our camera into my laptop, and that was about it.

Scott Nelson:    Okay. And so run through those four main…just so if anyone’s taking notes they can kind of get a clear idea. So you start out with a statement of purpose.

Ryan Squire:    Yeah.

Scott Nelson:    You put together emergency plans in case something went wrong during the actual procedure.

Ryan Squire:    Right. Right.

Scott Nelson:    You obviously consented the patient.

Ryan Squire:    Right.

Scott Nelson:    You made sure the physicians and staff were on board and understood the whole premise and the goals and how does was actually going to take place. Any other main steps that you…?

Ryan Squire:    Yeah, and then we did have…because it was important to have staff members that understood Twitter and Ustream and how to consume this stuff.

Scott Nelson:    Okay.

Ryan Squire:    And we had them not in the normal waiting room. We put them in a conference room so that we didn’t disrupt other people that were in the waiting room.

Scott Nelson:    Sure.

Ryan Squire:    And made sure the family was able to see this and ask questions.

Scott Nelson:    Okay. Okay.

Ryan Squire:    And so that was one other thing, because that was one of our goals, was to make sure that they were comfortable and able to see what was going on and ask questions. And actually, at one point, one of the patient’s stepdaughters had heard about it and was at Nationwide Children’s Hospital working down the street, and she was able to [00:31:32] bring it up and watch her stepdad surgery. [Laughs]

Scott Nelson:    And so what did these people do? Did they have to follow you on Twitter and then get just basically tweets? Is that kind of how they [00:31:47] this or did they just follow the hashtag?

Ryan Squire:    Yeah. Yeah, the way we set it up was with a hashtag, so it was osumcmako.

Scott Nelson:    Okay.

Ryan Squire:    And you can’t find it now because it’s been 10 days and after a week Twitter purges messages.

Scott Nelson:    Okay.

Ryan Squire:    But yeah, you can go back through the osu on Twitter. Ohio State University Medical Center is at osumc, and you can see some of the tweets about 10, 11 days ago.

Scott Nelson:    Okay.

Ryan Squire:    But yeah, we used a hashtag so that we were able to follow the hashtag, and also every 15 or 20 minutes we put out the feed for the live video.

Scott Nelson:    Okay.

Ryan Squire:    One of the things that I had read and then kind I’d kind of studied about this was that just tweeting the surgery didn’t do a whole lot for people to learn. They really have to have that visual component so that they can see what they’re talking about. I mean, when you watch the video, the video is almost two hours long but you can scroll through it on Ustream, and you can see the computer screen with the robotic arm and you can actually see the physician or what the physician sees, the surgeon sees, as they’re shaving away some of that bad bone.

Scott Nelson:    Okay.

Ryan Squire:    And what was really cool about that is, I mean, we can explain to people exactly how you get set up, what it looks like. And then the next day when Tom was in his hospital room, when I met with him just to see how he was doing and he had been up walking already, and brought my iPad, and Dr. Beal, the surgeon, was able to kind of run through with the surgery with Tom—not a generic surgery, but Tom surgery—and show him exactly what saw and explain to him what he did and kind of what went on in the room there when Tom was asleep.

Scott Nelson:    Huh.

Ryan Squire:    Extremely powerful for the patient.

Scott Nelson:    Yeah. I bet.

Ryan Squire:    Right?

Scott Nelson:    Oh yeah.

Ryan Squire:    I mean, to be able to see that and ask questions, “Hey, what’s that [00:33:46]?” “No, that was on because they wrap your legs in a certain way and put certain devices on.” “So what is that device? What are those things?” So there’s no more, “Hey, something happened to me and I don’t know what happened.”

Scott Nelson:    Sure.

Ryan Squire:    You can ask all those questions.

Scott Nelson:    Yeah.

Ryan Squire:    And it really helps that whole idea of participatory medicine.

Scott Nelson:    Mm-hmm.

Ryan Squire:    If the patient feels like they really understand what went on, then they’re going to participate more fully and deeper in their rehab and then in their recovery, and you could see that right in the room. You could see it happen.

Scott Nelson:    Yeah.

Ryan Squire:    Yeah, it’s incredible.

Scott Nelson:    Yeah, that’s an interesting concept. I haven’t really thought about that. By really engaging with that patient and kind of embracing that participatory kind of effect, that may even actually help them in their recovery and give them a little bit more ownership in the recovery, I guess, for lack of a better description.

Ryan Squire:    Sure.

Scott Nelson:    But that’s interesting. And you mentioned establishing that sort of emotional connection earlier on in our conversation, and I have to think you’re delivering something the next day or I can’t remember exactly when you said that you showed the patient what happened, but…

Ryan Squire:    Yeah, the next day.

Scott Nelson:    Yeah.

Ryan Squire:    We went in about noon the next day.

Scott Nelson:    So you’re delivering something that’s phenomenal—I have to think not [laughs] very many institutions have done this sort of thing—at a pretty emotional time, and so that’s incredible. I have to think that patient walks away raving about that.

Ryan Squire:    Yeah. The patient was very receptive. You know, you have to have the right patient too, right?

Scott Nelson:    Sure, yeah.

Ryan Squire:    I mean, this is part of why we talk to them upfront. Not everybody is going to want to see a video of themselves on an operating table. And of course he was draped, he couldn’t see his face or any of that, but that can be disturbing to people. My little brother faints at the sight of blood.

Scott Nelson:    Sure, yeah.

Ryan Squire:    Right? I mean, he’s a wimp.

Scott Nelson:    [Laughs]

Ryan Squire:    He’ll kill me for saying that. But some people just don’t have the capacity to handle it. Tom was fine and did fine and was really intrigued and interested, but yeah, I think that’s part of what medicine is trying to do, right?

Scott Nelson:    Mm-hmm.

Ryan Squire:    Is re-engage our customers as customers, not just as patients that we practice on but as customers that are involved in the process, because if we do that, our hope at Ohio State is that we can keep people healthier to begin with, right?

Scott Nelson:    Mm-hmm.

Ryan Squire:    That we can engage them emotionally a little bit earlier in the process when they’re still healthy, so that they don’t get sicker, so that they don’t end up with heart disease, so that we can help keep people well.

Scott Nelson:    Sure.

Ryan Squire:    That’s the concept of personalized medicine and P4 medicine, that whole, “Predict what’s wrong with me so you can prevent it from happening, personalize the treatment or the plan, and then help me participate in it.”

Scott Nelson:    Yeah.

Ryan Squire:    Those are the four P’s.

Scott Nelson:    Okay.

Ryan Squire:    And that’s something that we know through research and through behavioral medicine that we know people who are engaged and involved in their plan, they’re going to take the medications, they’re going to do what you ask, and why wouldn’t that be one of our goals every day?

Scott Nelson:    Sure. Sure. A couple of concluding questions in regard to this topic. Looking back, would you do anything differently then, if you were to coordinate another event like this?

Ryan Squire:    Yup, I would. We had forgotten the lavalier microphone.

Scott Nelson:    Okay.

Ryan Squire:    So one of the things we did—we had two surgeons who can do this MAKOplasty. Dr. Beal actually did the surgery, and Dr. Glassman, the other surgeon in our department who does MAKOplasty, he was actually sitting next to Mary Connolly, who was the one sending the tweets that day from our department.

Scott Nelson:    Okay.

Ryan Squire:    So Mary Connolly works in communications marketing. Dr. Glassman has never used Twitter before, but he was interested in it, so he learned a little bit about Twitter that day. But we wouldn’t expect Dr. Glassman to tweet if he’s never used Twitter before, so we sent the tweets but we used Dr. Glassman’s mind and he kind of walked us through what was happening that day.

Scott Nelson:    Okay.

Ryan Squire:    And so that was another detail that was very important to us, but what I didn’t do and what I should have done was I should have put a microphone on Dr. Glassman.

Scott Nelson:    Okay.

Ryan Squire:    We turned off the sound of the camera because we didn’t want to hear the banging and the—it sounds like a [00:38:24] tool.

Scott Nelson:    Sure. Yeah.

Ryan Squire:    And some of that other stuff, it’s just unnecessary, so we really didn’t want to scare people with that. But if I had put a microphone on Dr. Glassman as he’s walking us through this procedure, then we would have gotten even more context, right?

Scott Nelson:    Mm-hmm.

Ryan Squire:    And right from the surgeon’s mouth. And that’s something that I think next time we would be interested in doing, because there would have been even more information there from both a more medical perspective but also for patients too.

Scott Nelson:    Okay.

Ryan Squire:    Because lots of patients, it’s Dr. Glassman that’s going to be the one doing their surgery, and he’s very well-spoken. So that’s really the only thing that I would do different next time…

Scott Nelson:    Okay.

Ryan Squire:    …just put a little more in there, but otherwise I felt like the way we had thought about it was it worked very well for us.

Scott Nelson:    Mm-hmm. Okay. Kind of a twofold question—this is kind of my last question about this topic but twofold—one, do you plan on doing more of this in the future? And then, two, because I come from kind of the industry side of the med tech space, do you see yourself ever partnering with industry at all or are you going to kind of keep that separate?

Ryan Squire:    Yeah. So, the first, do we plan on doing this again? I think if the situation is right. I mean, we have lots of different innovative things that we do that I’m not going to say anything without talking to people first, but…

Scott Nelson:    Sure.

Ryan Squire:    …there are lots of things that we do, surgeries that we do, that yeah, I’d be very interested in showing people and walking people through because it’s amazing medicine and it’s amazing science.

Scott Nelson:    Mm-hmm.

Ryan Squire:    But you have to have all those things in place. The surgeon has to be comfortable. The patient has to be comfortable. And so those things are essential.

Scott Nelson:    Yup.

Ryan Squire:    You can try and teach all you want, but if those things aren’t happening, then you’re not doing the best thing for the patient or for the surgeon and that’s not going to work. So yeah, I mean, I think we’re absolutely interested in other ways that we can use these technologies to meet our goals…

Scott Nelson:    Okay. Okay.

Ryan Squire:    …and one of those ways is probably doing this again.

Scott Nelson:    Sure.

Ryan Squire:    And then looking at the things that we realize were really incredible, like the family’s ability to understand what’s going on in real time inside the operating room, that was very powerful for the family. The followup the next day where the surgeon could—I mean, surgeons obviously always follow up with patients, but where they could really walk through and show the patient what happened, that’s something that we’re interested in.

Scott Nelson:    Okay.

Ryan Squire:    And would we partner with anybody? I think if it was the right situation and it helped us meet our goal, then we’re always interested in partnerships and in collaborations with people.

Scott Nelson:    Sure.

Ryan Squire:    The only way to make an idea better is to work on it with a couple of people.

Scott Nelson:    Mm-hmm.

Ryan Squire:    And so yeah, I mean I think we’d be open to those things. It just would have to be the right situation for us, for the patient, again, for the surgeon.

Scott Nelson:    Okay. Okay. Very cool. And I know we’re running short on time, so let’s kind of conclude with this. We kind of hit it a little bit earlier, but you’ve been able to really create a very social-media-driven culture or at least allow for social media to become fairly mainstream within the culture there at Ohio State, and I have to think that’s far different than most institutions across the country. What would you say to the people that are listening that would say, “You know, social media can’t do much for me,” or “It’s just a fad or a waste of time?” What one or two things would you leave them with?

Ryan Squire:    So, social media is not a fad or a waste of time because, I go back to the definition, right?

Scott Nelson:    Uh-huh.

Ryan Squire:    It’s the democratization of information. You can see where in Middle Eastern countries that’s meant the difference in what kind of government they have. That kind of thing isn’t a fad. That doesn’t go away. That’s something that when people understand the power of it, they never put it down.

Scott Nelson:    Sure.

Ryan Squire:    They find new and different ways to use it, but that concept of the democratization of information is not going away. The idea that people are publishers and not just readers, that’s not going away. The fact that only one person in my town, the newspaper editor, doesn’t control everything that everybody reads is an extremely important concept, right? Because what if I don’t agree with what the newspaper publisher put in the paper that day?

Scott Nelson:    Mm-hmm.

Ryan Squire:    Well, now I can write my own version of the story, right? And post it on my blog and do a video on it and connect it to my Twitter friends and put it on Facebook.

Scott Nelson:    Sure.

Ryan Squire:    I mean, [laughs] so to say that these things are going to go away is silly.

Scott Nelson:    Mm-hmm.

Ryan Squire:    Is everybody going to understand the power and what it can do? No. But it is really important to find an advocate, to find somebody who does understand it, and either make them a part of your organization or partner with them from an agency-type perspective and start to learn more about what it might be able to do for your specific goals. I just think that that saying, “It isn’t for me,” is turning yourself off to business. And in fact, Erik Qualman, who’s the guy—a lot of people have seen the video with all the stats around social media.

Scott Nelson:    Mm-hmm.

Ryan Squire:    It’s called Socialnomics, is a book that he wrote. And then, if you search Socialnomics online, you’ll find a video with [00:44:15] updates all the time, with stats about people that use this stuff. I mean, 550 million people on Facebook aren’t going to just stop using Facebook tomorrow, okay?

Scott Nelson:    Mm-hmm.

Ryan Squire:    And so Erik Qualman is quoted as saying, “It’s the price of doing business. In five years, businesses who aren’t using this might not be doing business anymore.”

Scott Nelson:    Sure.

Ryan Squire:    I mean, I think that’s maybe taken a little bit too far a step…

Scott Nelson:    Mm-hmm.

Ryan Squire:    …but maybe in 10 years…

Scott Nelson:    Right.

Ryan Squire:    …certainly, if you expect to be doing a business in a space—look, if I’m listening to my customers and engaging them in the process and making them feel emotionally connected to medicine and to what’s happening to them, when they start telling people about them, start telling their friends, and more and more as that becomes the way we do business, they’re going to start to pick us over everybody else. That’s just human nature.

Scott Nelson:    Mm-hmm.

Ryan Squire:    They’re going to go to the place to expect every one of us to get them healthy. Right now, what they don’t necessarily expect is that incredible emotional connection to it and that we make them feel great in the meantime. And so if we can do that, we can create an experience. And the first companies to do that in the market are going to have a leg up, but eventually if you want to be doing business, you’re not going to be able to ignore that and the fact that your competitors are doing it.

Scott Nelson:    Sure. Yeah. Okay. Very cool. Ryan, I can’t thank you enough for coming on to the call. It’s really been fascinating to kind of pick your brain and understand a little bit more about what you’re doing, and especially as it pertains to kind of this recent live tweeting and Ustream surgery that you coordinated. So thanks again. The folks that are listening, where can they go and follow you or connect with you online?

Ryan Squire:    So I’m on Twitter. I’m OSUSquire.

Scott Nelson:    Okay.

Ryan Squire:    It’s O-S-U-S-Q-U-I-R-E. They can also find me on Facebook.com/OSUSquire.

Scott Nelson:    Okay.

Ryan Squire:    And those are the best ways to get a hold of me.

Scott Nelson:    Okay. Repeat those again. Facebook.com/OSUSquire?

Ryan Squire:    Right, and then Twitter.com/OSUSquire.

Scott Nelson:    OSUSquire, okay. Very good. Ryan, thanks again for coming on.

Ryan Squire:    No problem.

Scott Nelson:    This has really been a fascinating interview. I really appreciate it. I have followed Ryan on Twitter and become a fan on Facebook, so I encourage everyone to connect and check out Ryan online. So thanks again, Ryan. I really appreciate it.

Ryan Squire:    No problem. Thank you, Scott.

Scott Nelson:    Alright. Thanks everyone for listening.

 

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