• The CNS Social Media Experience

    Authors: Michele L. Hilgart
    Ashok R. Asthagiri
    Ganesh Rao
    Brian L. Hoh, MD, MBA
    Brian T. Ragel
    David Berg

    October 2010 to 2014

    Facebook launched a billion-user social media revolution in 2004. Online platforms such as Facebook, Twitter, YouTube, and LinkedIn allow for digital communication in almost real time. Although businesses struggle with how best to reach these large numbers of users, one thing is clear—social media is becoming the preferred mechanism by which people are obtaining news.

    The Congress of Neurological Surgeons serves thousands of members worldwide with the mission of enhancing health and improving lives through the advancement of neurosurgical education and innovation. Six years ago, the CNS recognized the large numbers of people utilizing Facebook and realized that these new social media outlets were the preferred mechanism by which younger member were not only obtaining daily news but also interacting with the world with comments of their own. The CNS saw social media as an opportunity to provide up-to-date educational content and society information, as well as provide an outlet to socialize on neurosurgical topics.

    Figure 1: Line graph depicting the number of CNS social media outlet users. Numbers represent Facebook likes, Twitter followers, LinkedIn followers, and YouTube subscribers from October 2010 to October 2014.

    Social Media Strategy
    In 2009, the CNS Information Technology Committee developed a social media strategy with a target audience to include all CNS members (i.e., academic neurosurgeons, private practice neurosurgeons, international neurosurgeons, domestic neurosurgical residents, international neurosurgical residents, and medical students). The CNS did not want to use social media for political purposes (e.g., to petition Congress) or to engage the general public. The following objectives were put forth: 1) promoting existing programs and products; 2) membership engagement by urging online posts and discussion; 3) professional networking; 4) pertinent news delivery; 5) collection of member ideas and opinions on existing programs; and 6) crowd-sourcing potential new ideas.

    *Refers to number of “followers” for Twitter, “likes” for Facebook, “subscribers” for YouTube, and “followers” for LinkedIn.
    Table 1: Numbers of followers and features of CNS social media outlets as of October 2014.

    Twitter Experience
    A Twitter account was opened in October 2010, prior to other social media platforms, because of its one-way communication format Twitter is used as a newsflash source to users and has the advantage of near real-time distribution. Disadvantages include the 140-character limit and the possibility of buried tweets. The CNS Twitter feed began in October 2010 and gained 1,781 followers in 48 months (Figure 1, Table 1). Twitter is best for short, continual updates, classified with a hashtag (“”) to help followers follow a particular subject of tweets. For example, the CNS used the hashtag CNS2014 for the 2014 CNS Annual Meeting to encourage member involvement. Interestingly, meeting attendees were using Twitter to comment on activities as they unfolded. This type of dialogue generated interattendee conversations about the programs and activities themselves. The ability to follow any comment with CNS2014 from any mobile device created a rich dialogue regarding the Annual Meeting on an entirely new level of digital-only involvement. After a year of Twitter experience, the CNS made the decision to open a Facebook page to take advantage of its two-way communication.

    Figure 2: Google Analytics chart showing sex and age demographics of people who have “liked” the CNS Facebook page, as of October 2014.

    In January 2012, the CNS Facebook page opened, allowing for open communication among users who “liked” the organization (Figure 1, Table 1). The majority of CNS Facebook users are male (72%) between the ages of 25 and 34 years (41%) (Figure 2) and reflect the age cohort exposed to social media in high school and college. Facebook comments can include text, photos, videos, or links. Advantages are its large following (i.e., more than one billion users), international use, and two-way dialogue. Disadvantages include privacy (e.g., security set forth by the Health Insurance Portability and Accountability Act of 1996), the inability to control advertisements, searchable comments (making communication difficult from both a HIPAA and a professional position), as well as the low usage among individuals in the over-45 age group—only 17% of CNS Facebook users (Figure 2). Also, continual monitoring is necessary to remove or respond to comments.

    With over 200 million users worldwide, LinkedIn is a professional social media site, whose goal is to create business relationships. The CNS LinkedIn page was created in January 2013; it increased from 4 to 1,637 followers in 22 months (Figure 1, Table 1). LinkedIn offers the advantage of improved control over which subscribers can see comments; this privacy measure ensures comments are not open to the general community. Three CNS member-only groups are currently in use: Electronic Medical Record (EMR) Group, with 14 members; the Program Directors Group, with 45 members; and the Case of the Month (COTM) Group, which can be joined by CNS-approved LinkedIn members. To date, CNS membership seems to connect with each other more than with the CNS as a professional society.

    The CNS YouTube video channel was started in October 2011, going from 3 to 216 subscribers and 12,352 video views on 19 videos in 36 months (Figure 1, Table 1). The majority of users are male (81%) from the United States, India, or United Kingdom. The advantages of YouTube are outstanding, free video delivery and the ease of embedding links into other online sites. Disadvantages include advertisements and the inability to view videos offline. The top five videos viewed were Surgery of Low Grade Gliomas (3,186), Spine: Odontoid Fractures Anterior Treatment (1,946), Spine: Odontoid Fractures Overview and Surgical Management (1,036), Low-Grade Gliomas: To Treat, When to Treat (1,004), and Pathologies Included in Low-Grade Gliomas (1,000).

    The Congress of Neurological Surgeons continues to gain social media experience with the goal of not only providing neurosurgeons with pertinent, up-to-date educational content, but also allowing an avenue for users to socialize on patient management topics relevant to our medical and surgical practices.

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