How Health Departments and First Response Agencies Can Use Twitter to Monitor Emergencies, Part 2

Yesterday, I talked about how local health departments (LHDs) can use social media to communicate about and monitor public health emergencies. I also talked about how to set up your own Twitter account. For nearly a year-and-a-half, I was the Risk Communication Director for the Indiana State Department of Health. I dealt with the media during public health emergencies, and took part in several incidents and training exercises.

A tool like Twitter would have been invaluable, and saved a lot of time and energy in getting valuable information to other first responders, the Incident Command structure, and even the media and public.

Be sure to visit yesterday’s post to see how to set up a Twitter account and what applications will make this extremely useful.

Today, I want to show what a Twitter exchange would look like.

A few more issues to take care of first:

1. GroupTweet is a web-based service that lets you send messages to an entire group, rather than sending something to all of your followers, or typing in their names one at a time. If you need to speak to, say, an entire POD or the entire EOC, set up a group in advance, and assign all the members of that group. Then, when you need to send a message to only those people, follow GroupTweet’s instructions.

2. For training exercises and real emergencies, it’s helpful to set up accounts for the different NIMS roles (e.g. ISDH_INCMD is the Incident Commander for the Indiana State Department of Health). As the shifts change, make sure the new people have the username and password to the Twitter account.

3. If you are using a special term or keyword during the incident, like “ISDH” or “anthrax,” you can use a program like Tweetfeed to monitor Twitter traffic. This will pick up all traffic with that keyword, so you may be inundated with more traffic than just your group.

4. Set up a laptop running TweetDeck with an LCD projector to show the message windows on the wall. Make sure everyone can see it, but try to squeeze as many tweets on the wall as you can. (Use the display settings in the Control Panel.) Everyone working in the EOC is using the EOC software, as well as their own Twitter account, but they will be able to see the Twitter stream on the wall. They will also be able to respond to the messages from their own station.

5. Make sure PIO has a separate, public Twitter account they can use to contact the media and public directly, rather than waiting for the TV news and newspapers. Updates are immediate and can be made as needed. Information given to a TV station could be obsolete 15 minutes after the van has left.

Also, use a #hashtag if you’re talking about a more common term AND your timeline is public. This will let other people, like the media and concerned citizens, also monitor what you’re doing. Anyone who is using an incident #hashtag will show up in the general Twitter timeline through Twitter’s search function at or TweetFeed (they show the same feed. There are not separate feeds for each program). This is an important way for the PIO to monitor Twitter traffic on the incident.

Here’s how Twitter can work during an emergency.

Scenario: During a POD deployment in Clark County, you’ve got too many volunteers in one POD, you’re running out of medication at another, and a TV news crew is on site, but the Clark County PIO is not available.

Normally to handle this, the Operations Officer from Pod#1 would have to call the EOC to find out if they need to redeploy the volunteers. Someone else would call to get more medicine. A third person would frantically be trying to track down the PIO, and running around to find her. I’ve been in the scenarios where all these things are playing out simultaneously, and it’s often hard to get an answer because everyone is searching for their own answer, or working on their own part of the incident, and can’t be found.

While Twitter won’t eliminate this problem, it can help alleviate some of this chaos by making information more readily available. Here’s how:

The volunteer supervisor sends a Tweet, followed by a response from the EOC Incident Commander

Clark_VOLSUP: Clark County POD #1 has 12 too many volunteers? Send home or send elsewhere?

ISDH_INCMD: POD #3, First Haven Church, needs new volunteers. Send 8 there. Rest can go home.

Clark_VOLSUP: They’re on their way.

POD#1_OPS:We’re running low on doxycyclin. Will be out in 2 hours. Does anyone have more?

POD#3_OPS:We have plenty. Will send volunteer with 5 cases.

POD#2_OPS:Sorry, we’ve got just enough. Might run short near end of day.

POD#1_OPS:Channel 4 from Louisville is on site. Can’t find @Clark_PIO. Does anyone know where she is?

ISDH_PIO:@Clark_PIO is caught in traffic. I’m on site, and can handle.

POD#1_OPS:We’ve just sent processed our 10,000th person. How’s everyone else doing?

POD#2_OPS:We’ve had 8,000.

POD#3_OPS:We’ve had 12,000.

ISDH_PIO:Can I share this with the media? Any talking points I should give?

EOC_OPS:@ISDH_INCMD says Yes. 30,000 people through PODs, everything running smooth, enough meds for all. All PODs should finish by 10 pm today.

ISDH_PIO:Understood. Will contact @ISDH_INCMD when interview is done.

This short exchange has accomplished a number of things:

  1. They saved a bunch of phone calls, and chasing down different people to get an answer.
  2. It allowed for flexibility of someone else answering for the Incident Commander. The IC could have been standing nearby, unable to type out an answer, so someone else was able to do it for them. By using the @ reply feature, the IC can also see that someone has done this. It’s not lost in the shuffle.
  3. Using the @ symbol also delivered messages to the intended people, but publicly, so others can answer. The person who received a reply answer (@IDSH_PIO) was able to get the information they needed, but so did everyone else. Now, if someone needs to know where the PIO is, they have that information, instead of racing around again, trying to find out.
  4. It creates a record of what happened, which will help write the After Action Report (AAR), plus it gives a written transcript of the conversation, if needed. Just copy and paste all the Tweets into an index as part of the AAR.
  5. Each POD Ops director was able to share the number of people processed through POD with everyone. Best of all, they did it without sending an email. The information was immediately accessible, visible, and available to everyone. Emails tend to get buried and forgotten.
  6. The ISDH PIO was able to pick up some useful information – the number of people through each POD – just by following the general timeline. He would not have found this out otherwise, because the Operations.
  7. The Incident Commander was able to give the most important talking points to the PIO in a matter of seconds, not minutes on the phone. Or worse, the PIO never being able to reach the Incident Commander on the phone.

There are many more ways health departments and first responders can use Twitter. In fact, there are several social media technologies that health departments can use:

  • Ning social network engine to create a closed social network for all local health departments;
  • create a blog to give the public quick news updates, post press releases, address any rumors, and serve as a news source to the media. (Blogging can also help you keep the public updated without waiting for news channels;
  • and, using a a href=””>wikito create and share information (password-protected, of course) among health departments concerning large scale events, such as pan flu.

I’ll write about these technologies in future posts. In the meantime, if you have any comments, questions, or stories about how you’ve used these technologies, leave a comment.

Resources for Crisis Communication Through Social Media

Originally posted at the blog

I just had an article published in a special report for members of the International Association of Business Communicators to communicate during the swine flu pandemic. (Cue the “Proud Moment” music!). Anyway, this inspired me to find other resources related to using social media for crisis communication. (And yeah, this includes a few of my blog posts.)

Useful Social Networking Apps for Crisis Communication

  • TweetDeck – Browser for Twitter. If you’re new to Twitter, get this!
  • NearbyTweets – Website search app to find Twitter users in your city or state.
  • – URL shortener. Use it on TweetDeck, and then track it with Twitalyzer or’s click tracker.
  • StatCounter – Measures website or blog traffic from minute to minute. Google Analytics is great, but they only update stats around 2:00 am EST. StatCounter may give you the numbers you need for rapid response during a crisis.
  • – Blog software hosted on their servers. Easy to use, especially if you’re not technically savvy. Owned by Google.
  • – Similar to Blogger: hosted on their servers. Not as easy to use as Blogger, but still pretty easy to use.
  • – Regular WordPress software. You download this and load it onto your server. You either need to be technically savvy, or know someone who is.
  • GoDaddy – Inexpensive server space and domain name (URL) registration. Not the best, but for cheap price and ease of use, it’s a pretty a good way to go. This blog is hosted on GoDaddy and uses


Blog posts, PDFs, and PowerPoint slide decks

If you can think of any others, please feel free to add them. If you add enough, I’ll do an addendum to this post.

How Social Media Can Help the Public Avoid the Swine Flu

Originally published on the blog.

I used to be the Risk Communication Director at the Indiana State Department of Health and one of the things we prepared for over and over was “pan flu.” At the time, we thought it was going to be the H5N1 bird flu, and we prepared by practicing drills, simulating events, writing tons of press releases, and creating processes to get information out to the media and public. Quickly.

The problem is the old model of sending out press releases via email was fast enough three years ago, but since the explosion of Twitter and social networking, and the decline of the traditional newspaper, people just aren’t getting their news through traditional methods anymore.

With social media, the public is getting their information as it happens, rather than waiting for a newspaper to publish day-old news, watching network news at certain times of the day, or cable news that only has time for a national focus, but nothing deeply local.

I’ve been using Twitter to get national news from sites like CNN, the BBC, and USA Today.

I’ve been watching the Google Maps case markers, the CDC’s swine flu investigation, and even listened to a couple of the CDC swine flu podcasts.

There are a few ways public health and first responders could use social media to educate the public, and get ahead of the rumor mongering and bad information that many people seem to perpetuate, whether accidentally or otherwise.

Create a Twitter account.

Someone posted a tweet today that the Twittersphere was talking about swine flu the most, so this is the place to start. Use Twitter to quickly answer questions, debunk rumors, and give out good information and news links.
1) Use the name of your agency AND the emergency (for example, IN_SwineFlu.)
2) Download TweetDeck from
3) Set up a search column for “#swineflu and swine flu.”
4) Use Twitter’s Find People function to find media outlets and journalists in your area, and follow them. They’ll follow you back.
5) Use to find other people around your area. Search for the city AND keywords like “#swineflu” and “swine flu” to find local people talking about those topics. Follow them, and they’ll follow you back.

Set up a blog

Don’t screw around with the rigamarole of getting your IT department to set up a blog on your agency’s server. They’ll have to ratify it in their bi-weekly committee meeting, and want to create a mission statement and all that crap. Use blogs to publish press releases, send out quick updates and stats, give information that can’t wait (i.e. locations of hospitals and medication).
1) Go to, and set up a blog for your agency (i.e. You COULD screw around with WordPress, which is actually better, but we’re going for speed here. Plus you can’t do this. . .
2) Set it up so you can send emails and texts to your blog. If you’re one of the lucky people who has a Blackberry, you can send blog updates that way. Ditto with photos.
3) Go to and have your blog automatically update your Twitter account.

Monitor your traffic

It’s important to monitor your traffic so you can know what messages are getting the most attention, what ones are being repeated, and where your biggest traffic sources are from.You need to know how many people are coming to your blog, reading your tweets, and paying attention to what you’re saying to know which areas you need to improve on.
1) Set up your TweetDeck URL shortener to use, not Tiny.url or any of the others.
2) Go to, and enter your Twitter ID. Scroll to the bottom of the page, and click on Return on Influence. You’ll be able to measure how many people have read your Tweets.
3) Install StatCounter into your blog. I usually like Google Analytics, but they only update around 3 am EST. StatCounter updates minute to minute.

Those are the basics of using social media to communicate with the public. If you have any questions or suggestions for best practices, post them here in the comments. I’ll put up new blog posts to answer big questions

In the meantime, please take a few minutes and watch this video to learn how to avoid spreading colds and flu, not just swine flu.