imageAfter former President Bill Clinton spoke at the American Society of Health-System Pharmacists (ASHP) Midyear Clinical Meeting in December, press releases described the overarching themes of his talk, which focused on the intersections among health, economics and politics.

But Rachelle “Shelly” Spiro, RPh, FASCP, a Las Vegas–based pharmacist and health care technology advocate, was impressed by something else the former president said. “Pres. Clinton gets medication advice from his local independent #pharmacist,” she reported to her nearly 650 Twitter followers.

“He said that after he’d had his heart attack, he goes and talks to his community pharmacist for advice,” said Ms. Spiro, who tweets using the name @shellyspiro. “That isn’t something that the media would capture, but I thought it was pertinent for my followers, and it got a lot of retweets.”

Twitter: It’s not just for Ashton Kutcher and the Kardashians. Health care providers, including pharmacists, are increasingly using Twitter professionally. Ms. Spiro was one of more than 500 attendees at ASHP Midyear who were tweeting items that they found intriguing or useful from the meeting, most of them using the hashtag #ashpmidyear. (See the “Getting Started” sidebar if you don’t know the difference between a hashtag and hash browns.)

“Those 500 individuals generated almost 3,000 tweets,” said Colleen Bush, ASHP’s market research manager (@mdgirl on Twitter). “We use a service that helps us measure the reach of social media like Twitter, and we were able to determine that about 160,000 people saw at least one tweet about our meeting.”

Many pharmacists, however, are just starting to become aware of Twitter as something they can use to make their jobs easier or to help their patients. ASHP surveys indicate that about 25% of pharmacy students regularly use Twitter, whereas 22% of new practitioners and only about 12% of pharmacists who have been in practice longer do.

So, if you’re like the majority of pharmacists in practice—even the “next generation”—this means that you have not yet adopted Twitter professionally. Why should you? What good is it? Is it just another Internet fad?

That’s what Kevin Clauson, PharmD, an assistant professor of pharmacy practice at Nova Southeastern University and the director of the Center for Consumer Health Informatics Research, both in Fort Lauderdale, Fla., thought initially.

“I saw it as just another useless social media electronic time-sink,” he said. “But then they had the disputed elections in Iran in summer 2009, and the U.S. State Department actually requested that Twitter not shut down for its scheduled weekend maintenance because it was the only source of independent information about the elections. I thought, wow, if the State Department considers it an important source, there must be something here.”

A few months later, Dr. Clauson attended the Medicine 2.0 2009 conference, a meeting that focused on social media, mobile apps and the Internet in health, medicine and biomedical research. “I saw how Twitter was being used professionally to integrate technology and health care by people attending that meeting, and I really got on board,” he said. Since then, Dr. Clauson (@kevinclauson) has become one of the more active pharmacists on Twitter, with nearly 1,700 followers and 3,800 tweets to date. Based on that experience, Twitter is “the single most useful professional communications tool I have,” he said.

That’s a pretty strong statement. How can a steady stream of 140-character-or-less commentaries beat out professional journals, societies and academic meetings? Because it’s all those things and more, Dr. Clauson said. “We can be guilty of being in a professional echo chamber, always hearing the same types of opinions and going to the same meetings. When I get on Twitter, I connect with people in pharmacy, nursing, medicine, policy, research and informatics from around the world. It’s a much broader community.”

Interested yet? If so, here are a few suggestions for steps you can take to maximize Twitter as a professional resource.


Filter information that can be used for maintaining current awareness. In other words, use Twitter to “curate” the endless fire-hose stream of information coming at you from all directions: journal articles, professional societies, departments of health, colleagues, public news sources and so on. Rather than scanning and scouring five, eight or 10 professional and trade journals every month, if you develop a good Twitter feed of reliable sources within your specialty, you’ll start getting alerted to the most interesting and relevant new articles the minute they post online. “By creating lists, filtering who I follow, and searching using different hashtags, I can pinpoint information and narrowly focus on what I’m looking for,” said Jerry Fahrni, PharmD, a product manager in pharmacy automation at Talyst, Inc. and a relative early adopter of Twitter (@jfahrni) who has 1,039 followers and has sent out well over 12,000 tweets to date.


Follow developments and ideas from pharmacy and medical conferences via hashtags. Can’t make it to #ashpmidyear? Just follow that hashtag and you won’t simply receive tweets from the society about the meeting, but also anything that your colleagues might find interesting—such as Ms. Spiro’s tweet on Bill Clinton’s collaboration with his community pharmacist.


Network and collaborate directly with other professionals working in your field. See someone tweeting about a topic that intrigues you? Send a direct message and open up a conversation.


Use Twitter as a tool for early detection of issues within the pharmacy profession. “Twitter can be a potential early warning system,” Dr. Clauson said. “Before public health problems, issues of patient safety and so on start showing up in professional journals, you’ll start hearing about them in your Twitter feed.”


Engage with patients and the public—not just receiving, but also sending out tweets of your own. You can promote services and events at your pharmacy, share journal articles you find intriguing, or retweet messages—that is, repost another person’s tweet—that you’ve received. This is what you do with Twitter after you’ve been using it for a while. Ideally, to make the most of Twitter professionally, Dr. Clauson said, spend a couple of months just sitting back and reading your feed, finding good people in your area to follow and learning how it works. Then you can start tweeting messages of your own and encouraging people—whether they are colleagues, community members or patients—to follow you.

As with any new technology, adopt Twitter with caution. “I crept into Twitter very slowly at first and watched what other people were doing for a while before I started sending my own messages,” Dr. Fahrni said. Remember, unlike Facebook, anyone can follow or find your posts on Twitter—you don’t have to “friend” them or set your privacy settings to the most open parameters imaginable before someone can read what you’ve posted. If you post something false, inflammatory or foolish on Twitter, it can easily be found by employers, patients and colleagues. And it should go without saying, but as with any other communications medium, health care professionals who use Twitter should never discuss any sort of personal health information that could run afoul of HIPAA.

When used properly, Dr. Fahrni said, Twitter can be much more of a time-saver than a time-waster—in effect, a personally curated filter for professional news. “When I’m eating breakfast or having lunch at my desk, I’ll pull my phone out and scan through my Twitter stream,” he said. “I’m extremely picky. I only follow about 200 people, and every so often I’ll go through my feed and stop following the ones who aren’t of interest anymore. That way, I keep everything useful and relevant.”

“There’s so much that’s happening so fast in pharmacy, and particularly within health information technology, that a medium like Twitter is particularly helpful,” said Ms. Spiro. “Blog posts and articles can take a lot of time. Twitter forces you to distill everything down to a short blurb containing what’s most important.”

—Gina Shaw

Getting Started on Twitter: The Basics

Sign up for an Account

It’s pretty simple to get started on Twitter. The first step is to visit and sign up for a free account and give yourself a Twitter username. Many people use some combination of their first and last names—like @kevinclauson. You could also add your professional degree, like janedoepharmd. You can only use upper- and lowercase letters, numbers and the underscore character. Also, be sure to fill out the brief description of yourself in your profile; it’s a great way for people with similar interests to find and follow you.

Accessing Content

There are a number of ways to read posts to Twitter, which are called “tweets.” You can just go to the Twitter website and log in. You also can use applications called clients, some free and some purchased at a nominal fee, to help sort and manage your incoming Twitter feed and your own tweets. Some of the most popular are Twitterific, HootSuite and Tweetdeck; which one is best for you will depend on what kind of computer or mobile device you’re using it on.

You start filtering the information you get on Twitter in two basic ways: finding good sources to “follow”—which means subscribing to their tweets so that everything they post shows up in your Twitter “feed” (a list of recent posts)—and searching for terms that are of interest to you.

Following is simple. If you like someone’s tweets, just search for that person in your Twitter client and then select “follow.” Bingo—you’ve subscribed to that person’s tweets. Searching for terms of interest—like “pharmacy” or “pharmacist”—isn’t as straightforward as you might think. If you just go onto Twitter and enter “pharmacist” in the search window, you’ll get every single tweet that mentions that word—like the recent joke about how drug dealers should call themselves “exotic pharmacists.”

One way to fine-tune your searches for content on Twitter is to understand and use hashtags—that is, the # symbol in front of important terms in the message. For example, tweets about ASHP Midyear contain the hashtag #ASHPmidyear. If you want to search for tweets that are really relevant to pharmacy practice, rather than all those that happen to mention the word, use the # symbol before whatever word you’re searching for.

For more tips on getting started, see sidebar, “Setting Up Your Twitter Feed.” And remember, Twitter itself can be of help; the site has tips for beginners at htttp:/​​groups/​31-twitter-basics.


Setting Up Your Twitter Feed

Sources for Pharmacy, Health Care and Health IT:

@JFahrni – Jerry Fahrni, PharmD. What’s new in pharmacy and technology, especially tablets.

@DrJeffCain – Jeff Cain, EdD, MS, University of Kentucky College of Pharmacy, Lexington. Top source on use of social media in pharmacy and education.

@MeganPharmD – Megan Hartranft, PharmD, University of Michigan Health System, Ann Arbor. Documenting her journey from student to resident to ...

@drwalker_rph – Dave Walker, RPh. Self-described “social media evangelist,” well-rounded source of information on medication therapy management and pharmacy practice.

@shellyspiro – Rachelle “Shelly” Spiro, RPh, FASCP. Pharmacy and health information technology.

@kevinclauson – Kevin Clauson, PharmD, Nova Southeastern University, Fort Lauderdale, Fla. Pharmacy and health informatics.

@poikonen – John Poikonen, PharmD, University of Massachusetts Memorial Healthcare, Worcester. Clinical informatics expert and frequent blogger on pharmacy-related technology trends (

@foxerinr — Erin Fox, PharmD, University of Utah Hospitals & Clinics, Salt Lake City. Drug shortage expert, key contributor to ASHP Drug Shortages Resource Center.

Good Hashtags for Pharmacy-Related Content






You can also build your hashtag list with specialty-specific terms, such as #pediatrics, #geriatrics, #diabetes, #oncology and so on.

Organizations and Publications To Follow



@pharmacists (APhA)






@commpharmacy (National Community Pharmacists Association)

You can also look for your state’s pharmacy association on Twitter—most state pharmacy organizations have a Twitter presence, and it’s a good way to track more local issues. The Missouri Pharmacy Association, for example, tweets at @thempa.

Lists To Follow

Pharmacy by @poikonen​poikonen/​pharmacy/​members

Pharmacy by @JFahrni​JFahrni/​pharmacy/​members

Suggested Reading

140 Health Care Uses for Twitter (by Phil Baumann, RN)​2009/​01/​16/​140-health-care-uses-for-twitter

Ten Ways To Increase Your Twitter Followers (by Kevin Rose)​2009/​01/​25/​kevin-rose-10-ways-to-increase-your-twitter-followers