Hello, and welcome to the social media and hepatology session at the liver meeting digital experience. My name is Christopher Koh, and I'm the course organizer for this exciting session. In this session, we will have three exciting talks given by people who are involved in advancing the use of social media in the field of liver disease, and who are also healthcare providers that take care of patients with liver disease. As you will see, their presentations are geared towards the full spectrum of healthcare professionals and scientists that serve as the membership of the AASLD. The first talk will be given by Dr. Niral Shah, whose talk is titled AASLD, Educating and Engaging in the Digital Age. The second talk will be given by Dr. Patricia Bloom on how to maintain professionalism on social media. The third talk will be given by Elizabeth Goetjer, whose talk is titled Social Media for the Advanced Practice Provider slash Allied Health Professional. Finally, we will have a session which we think will be very exciting and a treat for all. This session will be an academic debate related to social media, which is titled Facebook versus Twitter, which platform creates the biggest impact. This session will be moderated by Drs. Richard Kalman and Bilal Asif. Team Twitter will be represented by Dr. Atusa Rabi and Joanne Hatchett. Team Facebook will be represented by Dr. Austin Chiang and Andrew Reynolds. So strap in. This should be a real exciting session on social media and hepatology, and I hope that you are as excited as I am. Hi. My name is Neeral Shah. I'm from the University of Virginia, and today I will be giving this talk on the AASLD, Educating and Engaging in the Digital Age. I'm an associate professor at the University of Virginia and the GI Fellowship Program Director. My research interests include coagulation, liver disease, viral hepatitis, and medical education. I have no disclosures. My learning objectives I hope to share with you today is to hope to help you understand the habits of current learners, describe the role of cognitive load theory in designing resources, review the resources available through the digital platform at the AASLD, contrast the use of social media before and during the pandemic. Expansion of e-learning resources. When I was in medical school, I often carried around textbooks or handbooks, and they filled the pockets of my white coat. A lot of those resources have transitioned to smartphones, tablets, mobile devices. I think it's important that technology has definitely outpaced medical education, and sometimes it does take something like a cataclysmic event, like a pandemic, for education, for education to catch up to technology. For example, a lot of the digital experience of this conference, a lot of our use of video conferencing software has really accelerated due to the pandemic. In a similar way, our resources have definitely transitioned into an e-learning platform. Why is this important? Well, I think it's important that we're adapting to different generations. There was a term coined by Mark Prensky in 2001 regarding digital natives. These are people that are born in the current environment, surrounded by technology, smartphones, mobile devices. For example, someone who's born in the current era may learn how to use some of those mobile devices before they even learn how to tie their shoes. I think they're just surrounded by computers and screens at all times, and it's important for us that we're not born in that generation or in this generation to adapt our resources and cater to the learner. I think it's important to harness the enthusiasm for technology and really embrace it and move the goalposts forward. A modern learner, 5.19 billion people across the world access the internet through a mobile phone. On average, people are spending about 6 hours and 43 minutes on the internet every day. As of January 2020, the threshold of greater than 50% of this time spent on the internet no longer occurs on a desktop, but now occurs on a mobile device. I think these statistics are actually prior to 2019 or from 2019, so it's important to realize I think those numbers have only gone up. Information is expanding with incredible speed, and people are using mobile devices more than ever. In one study that was done in 2019, it was estimated that users are online about 27 times per day. In addition, they unlock their smartphone about nine times per hour. 70% of people were using search engines to answer any of their questions. What is cognitive load theory? Cognitive load theory is the theory that presenting information in an organized, intuitive manner is more easily digested by the learner. For example, if I gave you the example to remember the numbers 2, 8, 6, 4, that might be a little harder to remember 10 minutes later than if I gave you the example of remembering 2, 4, 6, 8, all of the even numbers consecutively. And I think presenting this information in an organized manner helps people remember it longer term. Why is this important? Well, if information such as our online presence is not presented in an intuitive manner or in an organized way, it's going to be harder for someone to use, a learner to use, or a user. In theory, we only have a limited amount of working memory in a finite capacity. So information that's more easily digested is more likely easily retained. Otherwise, there's a risk of overwhelming the learner. So why was this important in the website redesign that was recently done? The ASLD website was optimized for desktop and mobile devices, similar to the reasons that I brought up before about the majority of time being spent on the internet being on mobile devices at this point. It is a definitely cleaner interface with collapsible menus. This reduces some of the extraneous information, which may stress the cognitive load and the cognitive demands of the users. The ASLD also utilize a number of focus groups and use their input to determine what was more intuitive about the placement of some of these resources within these collapsible menus. From that came a most commonly viewed page on the website, and then this top static banner with the practice guidelines, the liver meeting, the ASLD foundation, and contact us. The static banner is there whenever you're surfing through any of the pages on the website, but these highly viewed pages are easily accessed by any user on the ASLD website. What about liver learning? Liver learning is a great resource that's provided by the ASLD, which collates and has collected webinars, accredited activities, other resources, and recorded conferences. There are endless amount of resources online. As I mentioned before, 70% of users are using the internet and using search engines to find information. So, for the ASLD to provide the access to the most up-to-date hepatology content anytime and anywhere that is basically endorsed by the society, it provides a great resource for our users and for our members. When resources are curated, endorsed, and organized, it allows us to create personalized learning plans for the users. Now, one of the good examples of this in recent times was the COVID-19 resources page, which was developed on liver learning, which has really streamlined a lot of the up-to-date information on the pandemic and the coronavirus. What about the ASLD journals app? Well, this app is available for smartphones and can be downloaded on the phone, and this allows for online and offline learning, sort of this blend of learning. All of the journals, such as liver transplantation, hepatology, are all included within this app. Users can surf through different issues, different journals, and find articles that are of interest to them. They can even save certain journal articles into a repository that they can then access later or possibly when they're offline. This asynchronous learning may be perfect for a user who is interested in an article but does not have time to read it at that moment. I think this combined resource of all the journals is very effective and very useful for our members. Social media, in 2020, two hours and 24 minutes of each day is spent on social media platforms. This has probably just increased during the pandemic. There may be no socialization in person, but there is a sense of need for community and connection. Some people often argue that social media and technology has actually reduced our interactions and our socialization. I would say that with people that you're in the same room with or around in your local environment, that might be true. I've seen people, maybe pre-pandemic, sitting at a table at a restaurant and both people on electronic phones or on their smartphones, or even you walk into a family's living room and two people are sitting on a couch with the TV on and each looking at their phones and watching a different program. However, I think conversely, in professional societies, this socialization can actually be increased through social media and through technology. It allows us to connect with people that are far away or at different institutions in an easier format. I think this is important to connect people with like interests. Let's look at the ASLD and the social media specifically for our members. This is two different graphics. One is the social media users pre-COVID. Another one is social media users post-COVID or during COVID. If we look at the left side, social media users pre-COVID in 2017, 2018, 2019 showed with the Twitter handle for ASLD, Twitter handle for ASLD President, and Twitter handle for ASLD Foundation. The number of users grew each year, where on average, they were adding about five users per day. Facebook also had a growth, however, it just added about three users per day. Instagram, a little less, added about less than one user per day. Let's fast forward to 2020, January 2020, April 2020, June 2020. In looking at those same Twitter handles, Facebook and Instagram, after and during the pandemic, Twitter has continuously added about 10 users per day. It seems to be a very popular avenue for our members to reach each other. Facebook continues to add about three users per day and Instagram about one user per day. The majority of the new users are coming onto Twitter and it's important to keep that in mind as we think about our professional society and our online presence. What about the Engage platform? This was a more recent development of the ASLD, the website I've included in the header. This is a networking platform that's based through special interest groups. What they've aimed to create are three types of communities, communities of practice, professional learning communities, and professional learning networks. Currently, we have 18 communities in the ASLD Engage platform and it's meant to combine people with common interests and link them up, create some dialogue between people, create a social experience with those who are passionate about topics similar to you. The largest communities within the Engage platform are the Early Career community with 1,600 members, the NAFLD NASH community with 975 members, and the Hepatitis B community with 600 members. Finally, some of my key takeaways for this presentation. The ASLD has leveraged social media and digital offerings to cater to the current learning environment. The use of these resources has steadily grown over time. The pandemic has accelerated our use of digital resources and it's important as a society we keep up with that pace. The ASLD.org website redesign has made a simpler, cleaner website that is formatted for desktop or mobile devices. Twitter seems to be the most popular social media channel for our members. And the community structure in the new Engage platform is a way for people of like interest to connect. I would like to acknowledge the Social Media and Technology Committee, which I sit on, Wick Davis, who is a staff member at the ASLD, and Christopher Ko, who is the chair of our committee and works at the NIH. Thank you for your time and I hope you enjoy the rest of your digital experience with the ASLD liver meeting. I'd like to thank the ASLD for inviting me to speak on how to maintain professionalism on social media. My name is Patricia Bloom and I'm a transplant hepatologist at the University of Michigan. These are my relevant disclosures. Hepatology has certainly grown in its presence on social media in the last few years, especially in the setting of a pandemic and virtual meetings, this presence is likely to grow. Since 2017, the ASLD has doubled its Facebook followers and nearly tripled its Twitter followers. As hepatology providers continue to use social media more and more, it's important to understand all the rules and expectations surrounding professional social media use. Even as you sit in your comfy sweatpants and your favorite 80s band t-shirt with a hole in it on a couch in your basement, thinking that no one can see you, anything that you post to social media in that moment is an extension of your professional self. As long as someone is able to identify you as your professional self on that social media account, anything you post there is as though you said it out loud in your office or during clinic. No matter how informal you feel when you post, your online presence is an extension of your professional self. As such, your online behavior should be aligned with the code of ethics you use in your workplace. Just as is true in your workplace, it is possible to have a personality online while still maintaining standards of professionalism. As you increasingly engage with social media, an early step should be to reach out to your department administrators and ask if they have a written social media policy. Many departments do not have such a policy, or the policy is too vague to truly guide behavior. But, if your department does have a policy, that policy can become important if its rules are discovered in hindsight after an incident. One thing your employer may ask you to do is include a disclaimer in your social media profile, like these Hepatology Twitter All-Stars, something along the lines of, tweets are my opinion and do not represent that of my employer. I'll talk more about these disclaimers in a few slides, but to be clear right off the bat, these disclaimers do not give you license to say anything you'd like on social media. But your employer may want you to include this disclaimer to protect their liability. Let's discuss a scenario. You post a tweet recommending a particular medication regimen for prophylaxis of variceal hemorrhage based on a recent article. A patient at another center replies to your tweet by stating they are not on that regimen and asking if you think they should switch. Let's talk about the two ways this could get you in trouble. First, it is important to avoid the impression or the reality that you are providing medical advice over social media. This impression can be avoided with clear disclaimers in your profile, but also in the framing of your social media communications. In scenario one, it would be essential to clarify that your social media comment was not medical advice. It may seem a little silly to imagine that someone could consider this example tweet to be specific personalized medical advice, but doctors have been sued before in similar situations, even without direct contact with that person or having reviewed their medical records. In this example, Dr. Oz was sued for recommending a home remedy for sleep ailments when it burned the feet of a diabetic man. Dr. Oz had never directly communicated with the man. While potentially obvious, I would be remiss if I did not mention that you should not diagnose or provide clinical consultation via social media. For one, you cannot securely review a patient's medical history over social media. Second, unless you are an official spokesperson of your institution, avoid giving the impression that you are speaking on their behalf. Your institution may object to you positioning your opinion as their official opinion, especially when it comes to politics or other hot-button issues. But even if you don't frame your opinion as their opinion, your virtual conduct will reflect on your employer if a viewer is able to discern your affiliation. As I mentioned before, some hepatologists include a disclaimer statement in their profile, something like, views are my own. Some employers recommend or require this, many do not, and many consumers of liver twitter do not currently use one. Disclaimer statements like this can be important in legal proceedings when the issue is whether the speaker was speaking on behalf of themselves or their institution. These disclaimers limit your institution's liability if you make it clear that you are not acting as their agent. However, these statements do not necessarily protect you from action by your institution or third parties. When posting opinions about clinical care, it's important for you to have a predetermined strategy for how to handle patient inquiries. This can be a bit of a tightrope. One strategy is to follow a strict policy of no engagement with patient inquiries on social media, and some providers have even included this in their profile disclaimer. Another strategy is to encourage patients to speak directly with their provider. There are certainly physicians who walk the line of offering feedback to patient inquiries without establishing a formal doctor-patient relationship. For instance, a study of how doctors use Twitter found an Iowa palliative care physician who considers it his responsibility to offer advice that helps patients to communicate with their own doctors. He stated, there are people who don't have access to this type of care. Sometimes people just want to be acknowledged when they're struggling. None of these approaches to patient inquiries is right or wrong. All approaches have pros and cons. Be mindful of what will work best for you given your role, comfort level with social media, and institutional guidelines. Scenario two. You find an excellent example of spider telangiectasia on a patient's skin exam and ask their permission to take a photograph. You then post this on social media with educational facts about telangiectasias. Patients have a right to privacy. Patients trust their doctors in part because of an unspoken understanding that information shared to the doctor is privileged and will not be shared. This assumed privacy is necessary for doctors to avoid complete histories. Privacy is not only an ethical obligation of healthcare professionals, but a legal one too. The Health Insurance Portability and Accountability Act, or HIPAA, of 1996 provided national standards for the security of electronic healthcare information and privacy protections for individually identifiable health information. In accordance with HIPAA, healthcare providers should not share information that identifies the specific individual patient. While it is permissible to share anecdotes and non-identifying aspects of the patient's care or case, sharing identifiable information infringes on an individual's rights. Some violations of HIPAA are obvious. For example, a doctor who posted pictures of a young female patient being treated for intoxication to Facebook and Instagram. A doctor who posted pictures of a young female patient being treated for intoxication to Facebook and Instagram. Or nursing home staff that sent Snapchat photos of residents and private moments to friends while on the job. However, there are some examples that are not quite as obvious, such as ER staffers who were fired for offering their condolences to a police officer killed in the line of duty on Facebook before his family was notified. If you plan to share any information or imagery regarding a specific patient, you must completely de-identify it and obtain specific informed consent. In terms of de-identifying patient information before posting, consider some of these questions. Could any detail be removed from the post and my educational point would still be made? Would the patient or friend or family member be able to identify them from what I've provided? Is there a tattoo or birthmark or any identifying material present? Is there any part of this description I can generalize, like an elderly woman as opposed to an 83-year-old woman? Patient cases can be really exciting, informative, and an educational aspect of our hepatology community on social media. But keep in mind that specific and detailed informed consent is the minimum requirement of posting a specific patient's case on social media. AASLD does not have specific recommendations around how to go about this consent, but there are some recommendations I've gathered from other organizations. Following all of these guidelines is time-intensive, for sure, but also represents the most conservative, safe approach. When you consent a patient for their case on social media, make sure to describe to them the content of the post. For example, in scenario two, make sure the patient has seen the photo that will be posted, as well as your description. You should inform the patient of the reason why you want to share their case on social media. This step increases transparency. You should also include which social media platforms are to be used. For example, a patient could be happy for their image to be placed on Twitter as none of their friends or family use it, but would be unhappy for their images to be on Facebook as they could be seen by those parties. The relative permanence of online content should also be discussed during consent. Finally, authorities on the subject recommend obtaining written consent and including a statement of patient consent on your social media post. Some authorities even recommend sharing that consent with a superior before posting to ensure there's a paper trail to confirm permission. Scenario three, your lab generated exciting preliminary results planned to be confirmed and validated in the coming weeks. After lab meeting, you are so excited and post the results on social media. Remember that social media is publicly available and semi-permanent. Consider social media posts as an extension of your lab or scientific platform. In that vein, I recommend only posting scientific content that you would otherwise publicize, like peer reviewed and published research or papers on a pre-print platform. With every post of scientific content, ensure the content is accurate, credit is appropriately given to authors, and conflicts of interest are disclosed. As the AASLD code of conduct states, all potential conflicts of interest that may bias the content from a scientific or personal perspective must be clearly disclosed. This is also true of sharing content from another account on Twitter that's called retweeting. Even if the content was not originally yours, it's important to validate its authenticity as much as possible before endorsing it. Scenario four, after a full day of endoscopy, you take a selfie in an empty endoscopy room and post the photo on a social media account with the caption, longest Monday ever. A post like this highlights several issues with professional use of social media. The first of which is that physicians are held to a different and higher standard of behavior than our peers. While this caption is completely benign on face value, now imagine reading it as the patient or family member who just underwent endoscopy with that physician. The patient might interpret the comment as a signal that the physician was fatigued and had not performed the exam to the highest standard. While the physician could say to a co-worker or friend, longest Monday ever, without personal judgment, this content on a professional social media page would be interpreted through a different lens. I think this quote from a publication by the Australian Dental Association makes this point well, and I'll paraphrase. While professionals are entitled to a private life, social media is not an extension of this. Also from Katie Duke at the Association for Healthcare Social Media meeting, if you don't feel comfortable sharing it in an elevator, then don't share it on social media. There often isn't a distinct line between personal and professional online personas. Even when acting in a personal regard, others may view or perceive your actions as one of a professional, since that's what you are. There are several approaches to separating the personal from professional. One is to have two separate accounts on a given platform. If your personal account can still be traced to you or your institution, all of the expectations of professional integrity still stand though. Another solution is to keep certain accounts like LinkedIn for professional activities, while using other accounts like Facebook or Instagram for personal ones. Those personal accounts could have stricter privacy settings to limit public access. Be especially conscientious when posting photos from in or around the hospital. Your hospital may have very clear and specific rules about posting photos taken within their facilities. Your employer may take action against you for posts like this, especially when they directly involve your job or photos taken on hospital grounds. Scenario four also raises the issue of the permanence and infinite audience reach of social media posts. While the provider in this scenario may think that they only have a few followers, and those followers are their friends, public social media accounts are actually accessible by anyone. In addition, many posts are searchable and can be found years later, like a skeleton in your closet. If you are watching this, you are already on the right track. Self-awareness is the most important first step when defining your approach to balancing your personal and professional use of social media. There are best practices to follow to ensure your online activity remains as professional as possible, including checking in with your institution on their social media policies. The AASLD does not have specific social media guidelines, though it does provide guidance on this web page. My takeaways are onlineU is an extension of professionalU. Consider using a disclaimer, avoid giving medical advice online, and de-identify patient content and obtain consent if needed. Thank you for listening. Good afternoon, everybody. Or I guess, perhaps, since this is on demand, it could be morning or night. Who knows? But I guess I should just say good day, everybody. This is Elizabeth Gocher. This is Elizabeth Gocher. I am a physician assistant and I work at Duke University Medical Center in Durham, North Carolina. I've been asked to come to you today and speak about social media for the advanced practice provider and the allied health professional. I am delighted that AASLD reached out to me to provide this talk in this course. One of the things that we're working really hard in AASLD is bringing our advanced practice providers and allies health professionals into the forefront of the organization, be more prominent with them. We know they're an integral part of hepatology practice and clinical care, and it's really great that they asked me to do this as part of the social media session. Full disclosure here, the things I'm talking about, the journey I'm going to tell you basically about my journey in social media is what I want to share with you today. None of the things here really are just applicable to just this group, to allied health providers and advanced practice providers. I really think this applies to all providers. I just hope that the voice coming from one of your peers helps you see why it might be something that you want to engage in and certainly a place where we can see it advance our careers and our professions. This is my disclosure slide, none of which have any relevance to the talk I'm doing today. A brief overview of what today's talk is going to hold. I'm going to look at some why-so-me, basically as we go through my journey and what it looked like for how I became a Twitter aficionado. We're going to look at a few how-tos. I'm definitely not an expert or the most proficient in this, but that's one of also the beauties I think I've learned from being on social media and on Twitter in particular is how you learn as you go and that you don't have to be an expert to get started, but a few how-tos is always a good place to get started. Lastly, I think we'll take a little bit of a sidetrack into why so-me can be used as a tool for more than self-promotion. I think we all think about Twitter being something that helps us promote our brand and be put us out there, but also might be a tool to be used in ways that we don't anticipate like leveling the playing field and helping support efforts at gender equity in medicine. So I'm going to take you through the beginning of start at the beginning of my so-me story and the beginning here is my page. Before I get too too far though, I do have to give some props and back up the story, but also do some definition of terms. I was embarrassed when I was asked to give this talk and I was looking at the outline and some of the questions they got put forward that I saw this so-me. So for anybody who is still wondering, so-me means social media as opposed to the hashtag so-me media movement. Also a good thing, but not the same thing. Hashtags are something that maybe we'll talk in other talks, other providers, other presenters will talk about, and they are something that's an advanced form or perhaps not too advanced form of social media participation, but so-me, not the same as a so-me movement. Beginning of my journey did go to, I had to give props out to Dr. Deborah Fisher. Dr. Fisher is in our group. She's amazing on the social media field as well as in her clinical work and research. Dr. Fisher gave a GI grand rounds at the request of our chief to talk to all of us in the GI division about social media presence and how it could benefit the GI division. And so thinking about that and thinking about some of those things she said, I've been twiddling around. Maybe I might do this, but at the same time, I was pretty sure my cell phone is the devil's work. You know, cell phones rob all my privacy. Why in the world would I want to do something where I'm putting myself out there and being public with my personal life potentially when I'm pretty convinced that we're all going to have all of our privacy corrupted all the time? So no way was I going into social media, but then we had a snowstorm. And so after a few, actually a day or two, I decided, well, maybe Deb's right. Let me just play around here and give it a shot. If anybody knows what snowstorms in North Carolina are about, they're really more like ice storms. It's the snow, it's the ice that happens. And so we were stuck for three full days, which gave me ample opportunity to start working on my Twitter page. Getting started on a page is always the most fun because you get to put what you want about you. I really am a big fan of baseball. And here in Durham, we have the Durham Bulls who are the minor league affiliate of the Tampa Bay Rays. So hence, I am a Tampa Bay Rays pseudo fan. As I come to you from this presentation, we're in the middle of the American League Championship playoffs, and I'm really hoping we might get a chance for the Rays to make it to the series this year. But here we are at my baseball field. We do get to find a nice picture that you can put up there. You want to make sure you get a picture that has a good profile of your face. This is one way that you're putting yourself out there. You're going to put something out there that people remember, and you want to put something that they remember about you, like a good picture. So making sure you have one of those out there and having a memorable background is one of the things that I think is really a fun thing to start doing, but also really helpful. The other thing I want to highlight about this particular tweet, if you can see, is this is one of my tweets recently, October 9th, after we had the Secretary of Health and Human Services for the state of North Carolina do our Medicine Grand Rounds and talking about COVID. And she also talked about leadership and women in leadership specifically. And it was so inspiring. I put it out there and we got lots of tweets back, but it also gives you a chance to both tweet out and talk about things that are important to you. So tweeting is not just about medical literature. It's also maybe about something that's happening right there in your institution. On my page, I made sure to put a few things. For those of you who are orienting yourself to what a Twitter page looks like, the arrow there is highlighting how many followers and followings I'm following. 326 people and I have 547 followers. So some people might say, well, isn't that, that's not many followers. Deb Fisher had thousands of followers and I have 1100 tweets and she has 27,000 tweets. The thing about this, it's not about popularity, like in school. We all want to be popular, but at the same time, Twitter is, but more about the connections you're making and the links that you're making and the tweets and the likes, the retweets, and so the number of followers actually doesn't necessarily define your success on Twitter. So don't get caught up in the numbers. Another thing you want to think about putting on your Twitter page is your, or link to your organization. Since I was, of course, my idea originally was to start out to try and follow my chief and support the brand and make do GI be out there. That was definitely something I put on, but it's also something that has led to connecting me within the Duke system more than I would have ever have expected. The number of people in my Duke system now that send me emails or in basket messages that say, Hey, are you, I think I saw you on Twitter. It's really cool. I got a mutual patient. Let's talk about, but they referenced my Twitter brand. Another interesting fact, fun fact, fun story was, well, not so fun in a way. I was in the emergency room with my dad, who also is a Gocher. And when we were all done taking care of my dad, the attending that night in the emergency room came to me and said, Hey, are you Goch PA that's on Twitter? And I said, why yes. And she said, well, I follow you. And now I have a buddy in the emergency room. So you make connections in lots of different ways. So when you're thinking about social media, I think a lot of people think about outside, outside of them, outside their world, far away around the world, or even across the United States or across the country they live in. But really it can be something that's very local. Another thing that I get really excited about and that I encourage people to do with their Twitter pages, homepages is to look at their initials and make sure they're putting out the ones that mean the most to them. So the things that mean the most to me are they, of course, my degrees that I, my, my certification, which is my job and my career, but also this one, double a SLD gave associate fellows. associate fellows, they're, uh, designated a class of fellowship for us. So I am now an associate fellow of double SLD and I was very excited and immediately added that to my Twitter feed. In addition to updating my CV as soon as that came through this year. So as hepatology associates, make sure if you're out there already and got your fellowship, you want to get it on your Twitter feed. And if you're not in a fellow, make sure you think about applying so you can get it on your Twitter feed. Once you get it set up. Twitter is about talking, promoting yourself, obviously, without getting your face and your name and your CV out there and making people aware of, of you in the world and one, but also it's about education. I have found that, uh, Twitter reading has been really helpful for me in my education and keeping up with literature. I think we all know that we have that now, I guess, virtual stack of journals since we do them electronically instead of paper and in the old days, back when I first started, I had the stack that was up to my eyeballs on my desk. And when that starts backing up, one of the things that's really helpful for me is to just click in on Twitter. Here is, you know, something that I know is a bite-sized piece of information. I can read the whole article or I can get this chunk from a reliable, this is about developing your connections and making sure you know who you're connecting with and they're reliable connections. But I know that I am getting good information here and I can look at this while I'm walking for the 15 minutes that I have to walk in from the parking or walk home from the parking, walk home to my parking spot. So making it, making you smarter is also what Twitter is doing. One of the things that's a cool feature of Twitter is the ability to make lists. And I confess these are my lists right now. I went everything double SLD. So anything that's there. And then I also have anything in Duke GI, but most importantly I have a sensei EBTapper. Everything EBTapper is all about things that are helpful. So he is my new Twitter sensei, but this list feature is one way where you have all the scrolling. You don't have to keep going up and down. If you can fill up these lists and then you can compile the people that you want to check on on a regular basis, instead of just watching for their posts as they come through. One of the other cool features that I like about Twitter is the likes. Because come on, who doesn't like being liked? This is a fun thing. And this is one of the things that I think gets a lot of denigration and diminution about Twitter. Like people just want to be liked and be loved. And what kind of education is that? And how could that be beneficial? And I would say in our current environment, anything that spreads joy and love and happiness is a really good thing. We need those positive vibes. So here's an example, some of the likes. Because it's not just about my personal being liked, but also being liked is what gets you spread, gets your news out there. The like button shows you who's liked you. And it also tells you where your information is going. Each of these people who like me, when they like me, then that post on their posts and all of their followers then see that they have liked me. Which then leads to those people then potentially looking me up and liking the tweet of my friend who liked it, or maybe even adding me as someone they follow. I have a lot. Clicking likes adds to followers, which kind of makes sense. Liking is a good thing. Love, good stuff spreads good stuff. So it comes back around and gets you a follower. Now, not everybody can be liked as much as EB Tapper, but we're all trying. Some of the tips that Dr. Fisher gave us, and I just full disclosure, she shared with me some of her recommendations. And so I was grateful for that. But also another, again, recognition of how making these connections, not just within my division, but also electronically, helps build your connectivity. Deb gave me some good practical things to think about when you're building your brand. You want to be consistent, and you want to have meaningful content. You want to be somebody who's knowing what you want to do. You want to be somebody who's known as tweeting things that are helpful, unless you want to be known as tweeting some things that are fluffy. But if you're looking for something as a strong brand, perhaps consistency and meaningfulness is what you're looking for. Diversify, meaning don't just overshare your own content constantly, and making sure you're making connections, and tweeting, and retweeting things, or commenting on things that are not just about a monotone. Because it helps you build your audience, and ensure that people feel you're genuine, and have some comprehensiveness in your information. I've already referenced how you build connections with your audience, but by mainly responding, and retweeting, and also liking. You want to look around for the right groups to join. I've got a list at the end. And also, Double A Decile D has some great support and recommendations in social media. And we're going to review that towards the end, and get a look at some good people and groups to follow. You also want to try and engage influencers. So when you put a tweet out there, you see an article, and you like what the author has said, go ahead and put a comment out there. Putting comments out there is the way you get connections, and get recognition, and also then learn more. And don't be afraid to jump into discussions. People are out there for a reason, looking for engagement. And so Twitter chats are your friends. Also from Dr. Fisher, some pitfalls. And that's unmoderated or unvetted content. That was pretty obvious, but it can be really easy. And since this is kind of addictive at times, you may find yourself tweeting, and retweeting, and liking things that actually you really think you need to hit the pause button on. So don't get over the top, and make sure you're still paying attention to what you're liking, or tweeting, retweeting. Make sure you're avoiding unprofessional contact. That seems to be a no-brainer. But in the electronic media world where we're disconnected, this is some place where it gets kind of easy to accidentally, in a really bad day or a really angry moment, put something out there that you really wish that you hadn't. Because once it's out there, you can't take it back. This is something I preach, I know, to all the young kids about this. But it applies to us as adults as well, especially in our stressful moments. Making sure you're checking in with your professional organization, meaning your employer, to see if they have particular rules or concerns about how they want you to manage your social media account, mainly about privacy. You don't want to start an account unless you nurture it. One of the slides that Deb puts up is about, I don't have it here because I couldn't find a good way to put it in, but I'll talk about it. Starting a Twitter account and starting your social media is like having a box of puppies. A free box of puppies was given to you, but you've got to grow them and nurture them along with your account. So make sure if you put your account out, you at least do a little bit of time to try and keep it developing if you want it to stay fresh and lively and gain you the brand that you want. And also important to make sure, if you're clear in your Twitter and tweets, that this is not a doctor-patient relationship. Because any advice that you provide, any specific medical questions, then creates a legal duty, and you want to avoid that. In addition, of course, to confidentiality and not posting anything that could be shared, that could be gotten, could be applied to a patient or a patient identified. In fact, our institution has a very clear rule that even if you think it can't be identified, the no-juke patients in any way are supposed to be in our social media. I'd imagine that's true for a lot of institutions out there as well. So that's just some brief things that I've gone through. I was really excited to see this come out this year, because ASLD has got you covered. So you think you might want to get into this social media thing, and you're wondering how to get started. Never you fear. There are some great resources out there, and you can jump right in here. Go to the website, and it takes you there. I've got the link that works for you. Some of the things that I was interested to see was in their social media guide was where to find content for posting. And so I thought this is great, and there's some liberal organizations on there you want to make sure that you follow and get connected with to try and see what's happening in those organizations. Some really great tweets coming out of there. If you look at AASLD members, we've got some of the biggies. Yeah, we got some biggies. We got the Prez. We got Patty Pringle. We got Adrian. We got some really biggies. We got the coming Prez. We got Lupe, and Dr. Locke, of course. But then, do you see something missing? Folks, there's no associates on this list. So let's get ourselves out there, and let's do better. We want to make sure that we are getting ourselves on this list of who to follow. So I hope that associates, after this is over with, are getting excited and want to see themselves on that list, because that's a pretty good profile, a pretty good crowd to be hanging out with. I want to take a little bit of a serious turn here. This was also something that Dr. Fisher talked about, and I think it's really interesting and, on the one hand, so obvious that it doesn't need saying, but I'm going to say it anyway. She talked about an article that was published in New England Journal Medicine by two women authors, two women physicians, about social media and the advancement of women physicians. And I know this is the associates section of the course, but I think this applies to all women in medicine, in all fields, in careers and career paths. We believe that virtual communities may offer women physicians additional coping mechanisms, provide new avenues for sharing information, and perhaps reduce stigma associated with sexual harassment, burnout, and workplace culture by allowing experiences to be shared and validated, perhaps lessening social isolation and feelings of loneliness or even self-blame. And again, that seems kind of obvious, in a way, because this is a forum that we can co-opt ourselves. We can advance ourselves. We can put ourselves out there. We don't need to wait for somebody else to do it. So I think that is worth doing. It doesn't rely on sponsorship, but even things that are more, things that you think through this, this doesn't rely on sponsorship or mentorship or conference invitations. These are areas in which women don't get as many invitations. They just don't get the same degree of opportunity in that regard. And this is a place where we can stick ourselves in and insert ourselves in. This provides far-reaching avenues to disseminating research. These tweets go around the world. So this is an opportunity that is above and beyond the publication, just the local publication area that you can do. This is a way to build professional relationships without going to meetings, without having, or even if you're at the meeting, you don't get to all the places you need to be or get asked to be on the panel or get asked to be in the room. You're in a place where you're creating your own room. And all of this then leading to other opportunities that are outside your typical realm, even speaking opportunities and other traditional career enhancing opportunities. So I really want to think about associates since we are majority female, that we look at the importance of them. In my closing thoughts now, I want to say that So Me is way more than self-promotion. It's a real way to augment your knowledge base. Who doesn't love likes? Good vibe spread. And we need that more than ever. I would recommend you start as a lurker, but you'll be tweeting before you know it because watch out, it's addictive. Think about Twitter debates. They are the bomb. It's like following a case on an ongoing basis. Find a friend who'll retreat what you start. I'm lucky to have Deborah Fisher as my champion retweeter. And Azel D tweets is our champion liker. And I want to always say thanks to WIC, the man behind the keyboard at ASAO tweets who retweets all the time. Thanks everyone. And I hope you have a good rest of the meeting. Hi, my name is Dr. Richard Kalman. And on behalf of my co-moderator, Dr. Bilal Asif, I'd like to thank you for joining us for this exciting opportunity to discuss the merits of different social media platforms and how they relate to medicine and hepatology. We will be discussing the utility of two of the most popular social media sites, Facebook and Twitter. In this debate, teams have been organized with one physician and one patient advocate. But unfortunately, due to unforeseen circumstances, our Facebook team is represented by just a physician. But I am sure you will see he's more than up to the task. Next slide. Although we considered other platforms including Instagram and TikTok, we chose Facebook and Twitter because these are two extremely popular services with both physicians and patients. Next slide. The subject of social media is critical not only because of the widespread use of this type of media, but also because in this day and age, there is a risk of spreading misinformation either intentionally or unintentionally. Pre-COVID, Americans averaged close to two and a half hours per day on social media. 90% of physicians use some form of social media personally and 65% use it professionally. Why is social media so popular? Well, this type of platform fosters a true sense of community and education. And to this end, AASLD has leveraged social media and digital offerings to allow for efficient learning and community engagement. Next slide. I now have the pleasure of introducing our two teams for this event. Team Twitter is represented by Dr. Atusa Rabi and Joanne Hatchett. Dr. Atusa Rabi is a graduate of Tehran University of Medical Sciences. In the United States, she completed a T32 grant before her internal medicine residency at John Hopkins Bayview Medical Center, followed by GI fellowships at University of Miami Jackson Memorial Hospital. She graduated from Transplant Hepatology Fellowship at John Hopkins Hospital in 2017 and joined the VA in Washington, DC right after and now serves as the Clinical Director of Hepatology. She is joined by Joanne Hatchett, the Medical Science Liaison for PSC Partners Seeking a Cure since December, 2019. She is a family nurse practitioner and strong advocate for care planning and family education. And before accepting the position at PSC Partners was a member of the Board of Directors. Additionally, she is a PSC caregiver. Joanne graduated from San Francisco State University with a BSN and received both her MSN as a Cardiopulmonary Clinical Nurse Specialist and Family Nurse Practitioner Post-Master Certification from UCSF. And she is now practicing as an Advanced Certified Hospice and Palliative Care Nurse. Team Facebook will be represented by Dr. Austin Chang, who is currently an Assistant Professor of Medicine at Jefferson Health in Philadelphia and serves as the Director of the Endoscopic Weight Loss Program and Chief Medical Social Media Officer for the health system. His GI and Bariatric Endoscopy Fellowship Training were completed at Brigham and Women's Hospital and his Advanced Endoscopy Training was at Jefferson. He is Founding President of the Association for Healthcare Social Media and has assisted in social media efforts with all major GI societies over the years. So without further ado, let's proceed to our first question. Question one. How has your social media platform allowed for the involvement of patients in their own healthcare and removed barriers to understanding treatment? All right so I'll be representing team Facebook so I'm assuming that this is my cue to talk about the platform so if you could advance the slide please. All right so I know we already went through a little bit of an overview of social media and medicine these days but I just want to emphasize that per one of the key social media healthcare social media marketing firms WeGo Health, 87 percent of surveyed individuals use Facebook to share health information and these graphics that you see here show that use of social media platforms as a source of news on the left as of July of 2020 the latest figures show that 46 percent use Facebook which is the greatest percentage of across all major platforms and likewise you can see that Facebook is up there for the world's most used social platforms in general. Next slide please. Some of the key advantages expressed by users are that there are no characters no character limit when you want to express your thoughts in a micro blogging fashion as opposed to Twitter for instance you can organize into groups through Facebook groups which are very popular and which allows you to participate in multiple concurrent forums and not just one forum at a time. Again Facebook as a platform has the greatest reach out there there are two billion active users per month and if you take into account Instagram which is also owned by Facebook that's another one billion users per month which far outnumbers the number of active users of Twitter. There are precision targeting and advertisements that you can adopt to get your message across on Facebook and there's also a multitude of features and interoperability in terms of crosstalk between Facebook and Instagram so it really varies up your content and there have been several publications out there thus far there are two here on the bottom right here that really both express that Facebook is the number one platform the patients go to for their health information in GI population so this is specific to IBD patients but there's a little more ahead so next slide please. So Facebook has a whole multitude of various different features and one of them is that it allows for app development through the Facebook platform and one of these apps has actually been featured in a publication and that's called the donor app and this is specifically for living organ donor transplants transplantation for liver transplant I believe and it allows patients to really tell their story in a structured fashion to kind of get the point across so that they can identify family members and community members who may be interested in contributing to their cause and so it hopes to impact this entire transplant process and it also compiles information that's relevant to this donor living donor transplant process in one spot so that you can access this information much more easily and you know that it's coming from reputable sources. In a survey of 350 users 50 percent of whom are transplant patients 36 percent who are caregivers and friends and 14 percent who are healthcare professionals 95 percent reported that Facebook actually led to a positive impact through a patient group on Facebook. Next slide please. I just want to share that in searching Facebook and health today there are another two great examples of using Facebook for to impact health and patient involvement so the first one is an insurance company that is unveiling their health insurance options through a Facebook community event and the other one is a health system that's hosting a Facebook live event to answer public questions about COVID-19 so those are two other examples of how the platform is being actively used to engage patients. Next slide. Thank you. So I think that one of the most interesting ways that Facebook has chosen to engage patients is Facebook preventive health which is really a direct kind of method of reaching patients and trying to impact patient outcomes in a way and what this is is that it's taking into consideration and collaborating with major organizations the American Cancer Society American Heart Association the CDC and American College of Cardiology to to really make it easy for patients to keep track of their checkups and make sure that they're not missing out on any recommended prevention measures or screening that need to be completed according to these organizations. Obviously working directly with these organizations ensures that it's coming from a reputable source that they're getting that it's not from some unverified source and it also allows for location tracking so that you are able to access care locally and you can also share your experience with family and friends. In terms of again this is all about removing barriers to understanding treatment and so there's also improved access to information through the get digital educational program that Facebook has hosted which is there which aims to improve health literacy across all ages and it also has certain features like on their Facebook and Instagram stories those brief live those brief videos that last for 24 hours where you can feature stay home stickers for instance to kind of it collates everyone who's using those stay home stickers so that you can kind of engage with others who are sharing the same similar experience as you are you know especially during the pandemic right now. All right I think I'm going to save the next slide for the following question even though I intended it for this initial question and I'm going to assume that my time is about up for this question so I will leave it at that for now. Hi, this is Joanne. Am I ready to start right now? I'm assuming I am. Thank you. I'd like to start by saying years ago, while a board member for PSC Partners was seeking a cure, the board was requested to participate in all social media platforms. I quickly became a fan of Twitter because there were endless, endless learning opportunities. There was access to educational webinars, newly published research, and clinical updates from resources that, prior to that, I'd never had access to. In addition, pictures, videos, all of the different documents add to that experience. Next slide, please. In addition, Twitter provides ways for the patient to become involved in conversations directly with liver and GI disease experts. The series of tweets... Oh, this is a different slide. I'm so sorry. So patients are able to talk to these different experts. They have access to, as I mentioned, research, education, different treatments, and that is all completely available and so easily accessible, plus it's so fast-paced. Next slide. Twitter removes barriers, and those barriers are the ability to have conversations, patient involvement. They can talk directly to the experts. The series of tweets on this slide are actually part of a direct Twitter conversation that occurred between a patient and physician following hashtag Monday Night IBD, which includes discussions, polling, and more. Quite the unique experience for patients. Next slide. Patients can also easily communicate with similar or other patient-related groups. The patient in this tweet actually was reaching out to hashtag DonateLive, telling his story, very supportive, exciting, while the hashtag or the retweet includes PSC support groups from around the world, plus several professional organizations. So through this, patients and caregivers may find they actually enjoy the challenge of composing tweets that have both a powerful message and reach out to other important contacts, all within that character limit. You are also able to thread comments so you can speak longer, but essentially there's plenty of opportunity within the character limit to do that, and it can be exciting and fun. Next slide. Next slide. So Twitter provides patient support, although some patients may avoid Twitter because it doesn't really feel like a private space, yet there are ways to overcome this. Hashtag IBD is an example of patients who are willing to publicly discuss their symptoms, how they feel and function, and the impacts of their quality of life. Patients will be more educated and have more interactions with healthcare providers. Their communication skills will grow, which improves their ability to actively work with their healthcare team, all of which can help remove barriers to treatments. Next slide. There are takeaways here. Through access to public education, patient education, communication, and support, patients can become actively involved and invested in their healthcare. Twitter conveys information. Thank you. Thank you so much for those fantastic presentations. We'll probably have a question. as well. But, you know, I was kind of surprised that there are so many people out there sharing their health data, both on Facebook and on Twitter. So, you know, I wonder, do you have a sense as to how this may be changing the physician-patient relationship in the future? I would respond to that saying that I'm hopeful that that openness helps with that. So often patients, they don't feel comfortable sharing some of the symptoms that people with chronic liver disease live with. How many people want to talk about their brain fog, their hepatic encephalopathy, and how that truly affects their life or fatigue. So hopefully this will open that up. I would like to echo what Joanne said in terms of, you know, giving patients a forum to share what they sometimes would otherwise not feel comfortable sharing. And I also think that, you know, some of these platforms like Facebook, for instance, with groups can really collate what everyone has to say. If all patients share in a single forum, their experience with a medication, a treatment, a health professional, that can help others inform others as to how to pursue treatment, and also help inform health professionals as to, you know, certain things that they otherwise may not have been aware of. I know that social media has had an impact on certain medications, for instance, in the past where certain symptoms and experiences with treatments were not foreseen and ultimately led to certain warnings and changes in labeling and things like that. Thank you. Thank you both for your excellent presentations. I do have one quick question. You both discussed patients being involved in their own health care through both those individual platforms. And to that end, have either of you brought the idea of social media in health care to your patients in their own health care? I'll go ahead and respond. Absolutely, yes. I think to encourage that we know patients are on social media. There's no question. And so we should try to encourage that. And that's where having that relationship and being able to discuss it, I think, actually brings patients more comfortable with talking about what's important to them. I totally agree. I love engaging with patients online, although I think that I am very sensitive to the type of boundaries, professional boundaries that exist. And so I make certain that any sort of medical advice questions are deferred to the in-person setting. But otherwise, you know, I think that I don't proactively ask my patients to engage with me online, but I think they're many of them in the process of looking me up before coming to see me end up engaging with me on social media. And I think that I've gotten only positive feedback. Excellent. Thank you. And I think with that, we'll move on to the second question. Next slide, please. Thank you. So our next question is the following. How does your social media platform, Facebook or Twitter, combat medical misinformation in the period of fake news? And next slide. And we'll start off with Dr. Cheng. All right. So I don't know if we can go back to the last slide that from my, I know I'm going out of sequence. I'm so sorry. But I thought I figured I would save this slide for this question because it does kind of help answer this question as well. So one of the steps that Facebook has done to really make sure that to combat misinformation is to really create these information hubs that limit the information to reputable sources. And they've done this for certain topics, obviously, with the current pandemic, which has seen traffic of upwards of 600 million people visiting this Coronavirus Information Center. Additionally, mental health is another hub that they've created. And they have specific resources that sort of just allow patients to easily access information that's reputable and screen out a lot of the misinformation and disinformation that they may be coming across on the Internet. I think other things that come to mind are helpful reminders, for instance, with in with regards to the pandemic, wearing masks and, and, you know, the reasons why wearing masks are helpful. I think those pop ups now exist on the platform. And a lot of this, again, did not come about until the pandemic really highlighted the need for it. But if we can advance to my next slide, which I know is a couple steps ahead. Thank you very much. Um, so the platform has decided, you know, has been giving continuous updates throughout the pandemic, but they have taken a more active stance in removing content that they deem is coming from, you know, unverified sources or is actually causing harm. They're also banning certain groups like anti vaccine groups and other groups that they deem are again, putting out misinformation or disinformation. And that also translates into advertisements specific to Coronavirus. They've been banning advertisements across the board for hand sanitizers and face masks and things like that so that they can make sure that there is they have greater control over what is being put out there. In terms of health information, verification of certain individuals and groups is also one way that they have taken and I know that that's not unique to Facebook as a platform, but to try to identify, you know, who is actually behind the account, I think is really important. Context warnings, I think is also something that we may not think about readily, but they actually in April of this year, have 15 million labels put on different pieces of content to sort of put things in context. So for instance, it's a reminder saying that, you know, that this is not a verified source, or, or that this example that you see on the screen there, I know the text might be a little small, shows that, you know, the article was actually from several months ago, or from or from several years ago, because I think they specifically noted that the timeliness of an article really made a difference. And they also, for people who were previously exposed to misinformation, they are able to show certain types of information or verified information on people's feeds. They also redirect users to official sources across all platforms. You know, I think one unique feature was on WhatsApp, which is owned by Facebook with a WHO health alert. And as of May of this year, there were 350 million people who clicked through these redirected sources. Next slide, please. Oh, okay. All right. So with that, we'll turn it over to Dr. Rabi for the Twitter presentation. Well, thank you for the opportunity to participate in this debate on how does your social media platform combat medical misinformation, and I'm going to represent the pro-Twitter side. As mentioned, there has been a growing public health concern over medical misinformation in different social media platforms. Medical community has a responsibility and really power to combat the spread of fake news. And I would like to discuss the role of Twitter and more specifically, liberal Twitter, I guess, in combating this problem. We can advance to the next slide. So I want to start with, first of all, the problem. So social media makes it easy to promote only ideas we agree with and ignoring those we don't. When one person's motivation is to promote one's own values and goals, and there is no incentive to include the other side, it is misinformation in and by itself. In general, there is also no peer review process or fact checker. Only recently have social media companies taken it upon themselves to limit the spread of misinformation through the monitoring of social media claims. Can I advance to the next slide? Liberal Twitter community, which I have actually had the pleasure of joining only last year at the last year's ASLD meeting, has collectively made efforts to address this in various ways. I consider this space a safe space for respectful debate backed up by evidence-based medicine. There is plenty of room for anecdotes and obviously personal opinions, but data backed up by peer-reviewed research is the mainstay of this platform. Many journals and researchers have definitely used this platform to discuss and disseminate information. Altmetrics is a great way of basically showing the impact of Twitter on dissemination of one's research. This, in turn, gives them the ability to interact directly with public as well as other professionals while presenting their research. If you could advance to the next slide, please. Furthermore, this platform allows us to interact directly with patients and promote awareness and combat misconception using multiple variety of things such as videos, hyperlinks. Although we recognize that many of our patients are actually not on Twitter, and there's certainly room to expand on this aspect. Here you can see different examples actually across the globe addressing patients directly on issues related to colon cancer awareness, cirrhosis diagnosis, fatty liver, and such. If you could advance to the next slide, please. There are also specific platforms that are basically designed to disseminate patient and provider information on a schedule basis, as you can see here, throughout the week. Crowdsourcing in the most efficient way is really possible on Twitter. Really, no other platform is possible to compose all tips and tricks that experts and also everyday clinicians would have on management of, for example, variceal bleed from people across the globe over the matter of two to three days. If you could advance to the next slide, please. In summary, I would say our common goal in liver Twitter across the globe is and should be to learn. When we set up the goal as learning experience, this promotes seeking out different opinions and a focus on asking questions rather than just making statements. You can advance to the next slide. Okay. Thank you for your attention. We hope you join us on liver Twitter. Thank you so much, Dr. Cheng and Ravi for your excellent talks. I do have one question. You both talked about the importance of making sure the information you get is verifiable and that it is accurate. As academic gastroenterologists and hepatologists, I wanted to ask both of you, what do you think the role of social media is in the education of trainees in this field, specifically when it comes to misinformation? I can go first. I do think that there is a role to improve on this, but I don't think improve on this. As I said, there are specific multifaceted platforms that we have throughout the week. There are different things such as Monday Night IBD or GI Journal Club. I think the fact that there are multiple experts from different subspecialty, that definitely helps, but that would not prevent sharing personal experiences or personal opinions. I would think that part of the responsibility should be also on the trainee as far as fact checking before really accepting a tweet as evidence or matter of fact without asking for evidence backing it up. I would have to agree with that. I think that some of the onus does fall on the trainee and certain platforms lend itself better to engaging with thought leaders and colleagues, professional colleagues who you can identify as reliable sources of information. I think for the general public, it might be a little bit different. One thing that I didn't mention because I realized halfway through that I had an additional slide that I didn't submit, but the idea is that I think one key thing is that these platforms are working with fact-checking organizations. I think that my guess is that these fact-checking organizations don't include professional societies, but it's something that potentially in the future they can work on if they really want to delve further into the healthcare space. Thank you. Thank you again so much for this excellent second part of the presentation. My question really for Dr. Rabi and Dr. Chang comes to the echo chamber effect that you mentioned, Dr. Rabi. I wonder in the setting of misinformation, I think this is a particularly dangerous problem. Is there anything unique to your platform that might potentially combat this echo chamber effect? So I would say that if there is more involvement from societies in journals per se, accompanying people who are publishing their data, that would be kind of a peer review process in my mind. So I have seen more and more as opposed to people actually coming up and summarizing a research study, journals have taken this upon themselves. Obviously, the platform belongs to everybody and everybody can participate, but this I think will eliminate that factor of taking the opinion of a person summarizing a research study just based upon their own opinion. Yeah. I think there are several things. I think in some ways it's challenging because part of the goal of these social media platforms is to attract the user. And that means kind of catering to one's interests. And so all of these platforms will sort of naturally guide you to your own interests and thereby creating an echo chamber for yourself. That said, I think certain platforms like Facebook allow for participation in multiple different groups, which might mitigate the fact that if you're on Twitter, for instance, or Instagram or some other platforms, you're seeing a single feed and that single feed is really only curated to your interests. But I think that it's an evolving landscape right now. As we can see from today's news, actually some of the platforms are coming under fire because of censorship. And with the current political climate, I think it's all in evolution right now. Thank you. Great. Well, thank you both so much. We're going to wrap up. I want to thank our panelists for really well presented, well argued debates. We heard really engaging facts and opinions about how patients take charge of their healthcare when it comes to social media, as well as combating the potential misinformation when it comes to healthcare on social media as well. We'd like to thank the ASLD, Cindy Smith, Wick Davis, and Dr. Christopher Koh for hosting today's debate on this important topic. Again, the panelists and on behalf of my co-moderator, Dr. Richard Coleman and myself, thank you again for participating. Thank you all. Thank you. Hi, hello. My name is Christopher Koh and I'm the course organizer for the social media and hepatology session. I hope that you have all had a wonderful experience during our session today. And I specifically like to thank all of our participants and speakers and also you, the audience, as we all join in this adventure of utilizing social media and medicine. And with that, this concludes.

liver meeting

social media

hepatology

educating

connecting

sharing information

Twitter

Facebook

professional branding

medical misinformation

patient engagement

evidence-based practices