title: Use of social media across US hospitals: descriptive analysis of adoption and utilization.
abstract: BACKGROUND
  Use of social media has become widespread across the United States. Although businesses have invested in social media to engage consumers and promote products, less is known about the extent to which hospitals are using social media to interact with patients and promote health.
  
  
  OBJECTIVE
  The aim was to investigate the relationship between hospital social media extent of adoption and utilization relative to hospital characteristics.
  
  
  METHODS
  We conducted a cross-sectional review of hospital-related activity on 4 social media platforms: Facebook, Twitter, Yelp, and Foursquare. All US hospitals were included that reported complete data for the Centers for Medicare and Medicaid Services Hospital Consumer Assessment of Healthcare Providers and Systems survey and the American Hospital Association Annual Survey. We reviewed hospital social media webpages to determine the extent of adoption relative to hospital characteristics, including geographic region, urban designation, bed size, ownership type, and teaching status. Social media utilization was estimated from user activity specific to each social media platform, including number of Facebook likes, Twitter followers, Foursquare check-ins, and Yelp reviews.
  
  
  RESULTS
  Adoption of social media varied across hospitals with 94.41% (3351/3371) having a Facebook page and 50.82% (1713/3371) having a Twitter account. A majority of hospitals had a Yelp page (99.14%, 3342/3371) and almost all hospitals had check-ins on Foursquare (99.41%, 3351/3371). Large, urban, private nonprofit, and teaching hospitals were more likely to have higher utilization of these accounts.
  
  
  CONCLUSIONS
  Although most hospitals adopted at least one social media platform, utilization of social media varied according to several hospital characteristics. This preliminary investigation of social media adoption and utilization among US hospitals provides the framework for future studies investigating the effect of social media on patient outcomes, including links between social media use and the quality of hospital care and services.
authors.affiliation: Penn Social Media and Health Innovation Lab, University of Pennsylvania, Philadelphia, PA, United States.
authors.forename: Heather M
authors.identifier: http://orcid.org/0000-0002-9284-4707
authors.initials: HM
authors.lastname: Griffis
authors.forename: Austin S
authors.identifier: http://orcid.org/0000-0002-3141-1772
authors.initials: AS
authors.lastname: Kilaru
authors.forename: Rachel M
authors.identifier: http://orcid.org/0000-0003-3435-4221
authors.initials: RM
authors.lastname: Werner
authors.forename: David A
authors.identifier: http://orcid.org/0000-0002-7970-286X
authors.initials: DA
authors.lastname: Asch
authors.forename: John C
authors.identifier: http://orcid.org/0000-0003-0096-8997
authors.initials: JC
authors.lastname: Hershey
authors.forename: Shawndra
authors.identifier: http://orcid.org/0000-0003-1980-727X
authors.initials: S
authors.lastname: Hill
authors.forename: Yoonhee P
authors.identifier: http://orcid.org/0000-0003-3525-1697
authors.initials: YP
authors.lastname: Ha
authors.forename: Allison
authors.identifier: http://orcid.org/0000-0002-7574-5360
authors.initials: A
authors.lastname: Sellers
authors.forename: Kevin
authors.identifier: http://orcid.org/0000-0001-9930-2575
authors.initials: K
authors.lastname: Mahoney
authors.forename: Raina M
authors.identifier: http://orcid.org/0000-0002-9801-6881
authors.initials: RM
authors.lastname: Merchant
mesh_terms: D003430:Cross-Sectional Studies; D006761:Hospitals; D020407:Internet / Q000706:statistics & numerical data; D008389:Marketing of Health Services / Q000379:methods*; D009936:Organizational Innovation; D061108:Social Media / Q000706:statistics & numerical data*; D014481:United States
keywords: Internet; health information; social media