by David Nash, MD, MBA
In its current listing of online social networks, Wikipedia presents 156 major, active websites. A neighboring link to view “now-defunct” sites accompanies the listing — a subtle reminder of the Internet’s competitive and volatile environment where promising endeavors rise and fall overnight.
But although the popularity of a specific website may fade with time, the practice of online social networking is here to stay.
In its simplest form, online social networking is a means for communication and collaboration enabled by the Internet.
People tend to use the terms “social media” and “social networking” interchangeably, but some argue that websites focused on dissemination and broadcasting of information (e.g. YouTube) are social media sites whereas sites focused on developing and maintaining a network of relationships are social networking sites (e.g. Linked-In).
Facebook and Twitter are examples of tools that do both functions very well.
Whatever the type of site, though, all the players in the healthcare arena — patients, providers, and not-for-profit organizations – are reacting to this game-changing means of information exchange.
Patients: Autonomy and Personal Responsibility
For the public at large, social networking sites are not only other sources of health information, but they’re aiding a larger movement in healthcare – one that puts the patient in the driver’s seat.
Increased personal responsibility for health, touted by many as a necessity for health reform, will inevitably lead to more individual discretion regarding where to go for health information and whose advice to take.
It’s important to distinguish between popular, generalist, social networks like Facebook and MySpace, though, and online health communities such as PatientsLikeMe and DailyStrength.
The latter health-focused social networks have an important distinguishing characteristic — complete anonymity.
Online health social networks provide an opportunity to freely obtain and disclose information about a health condition without having to divulge one’s identity.
Social networking expands the Internet’s utility to patients — from simply searching and reading posted content to participating in open dialogues about a health topic.
The power of dialogues between peers, especially those who share a particular ailment or health interest, can alter fundamental decisions consumers make about the healthcare they seek.
All healthcare stakeholders would do well to recognize the practical applications of social networks and their impact on patient behavior.
And rather than discouraging patients from searching and learning about their conditions via social networking sites, physicians and other providers should proactively encourage self-education while emphasizing the importance of caution, skepticism, and the necessity of verifying information with appropriate providers.
Providers: Communication and Information Dissemination
To healthcare providers (physicians, hospitals, and other health professionals), social networking offers opportunities to improve communication and marketing — and simultaneously challenges their traditional dominance as the only source of healthcare information.
It’s no secret that communication failures plague our healthcare delivery system. Basic communication breakdowns have been shown to cause medical errors, duplicative imaging and testing, and overall poor care coordination.
Provider-to-provider communication inside and outside of the hospital has been inconsistent or nonexistent.
Moreover, provider-to-patient communication has been lacking in terms of continuity, convenience, and immediacy.
Social networks could potentially improve communication by establishing permanent channels (network connections) among multiple physicians and between physicians and patients.
Communication between providers could be improved through widespread participation in online physician communities.
Surprisingly, a recent survey by Manhattan Research found that 60% of physicians are already using, or are interested in using, online physician communities.
Although these physician communities are not likely to improve patient hand-offs in the hospital or improve care coordination between family physicians and specialists, they do create an environment that facilitates sharing of information, especially as it relates to disseminating best practices and clinical decision support.
The implications of social networking for the doctor-patient relationship are less clear.
On the one hand, social networking (on a secure site) provides physicians with a means of communicating with patients on a continuous basis that is less time-consuming – and perhaps more cost effective — than other methods.
On the other hand, patient privacy and patient expectations of a physician’s responsiveness through social networking channels are possible obstacles to using these tools in practice.
Hospitals are using social networks less as interactive forums and more as a means of disseminating information, for example, to improve their visibility and facilitate patient loyalty.
The most common use of social networks by hospitals is sending updates and news regarding their respective institutions.
According to Ed Bennett at the University of Maryland Medical System (ebennett.org), as of August 19, 2009, there were 253 hospital Twitter Accounts (the most popular being Henry Ford Health System), 174 hospital Facebook Pages, and 174 hospital YouTube Channels.
Not-for-Profits: Advocacy and Mobilization
Perhaps more than any other healthcare stakeholder, not-for-profit (NFP) organizations have rapidly embraced and utilized social networks — for a variety of purposes including membership recruitment, fundraising, communicating with volunteers, announcing news and legislative developments, and basic event planning.
The widely publicized grassroots campaigns for and against healthcare reform this spring and summer were propagated by social networks, further increasing their visibility and impact.
In summary, regardless of the popularity of Twitter, or Facebook, or any other single site five years from now, online social networking and social media are destined to become fundamentals in communication paradigms of healthcare stakeholders and second nature to healthcare consumers.
The Internet characteristically brings new technologies and capabilities quickly to everyone’s desktop with little regard for conventional orientations or transition periods. Healthcare stakeholders who choose to educate themselves about these tools will be better off than those who do not.
Communication continues to be a critical weakness of our healthcare delivery system. This is inexcusable at a time when communication technologies are instantaneous, convenient, and affordable.
Social networking and social media tools exist to facilitate communication and collaboration. These tools make possible what was only recently impractical in healthcare — trans-regional clinician collaboration on challenging cases, patients participating in support groups without having to leave the privacy of their homes, and mobilization of millions through free web-based broadcasting systems, to name just a few.
David B. Nash is Founding Dean of the Jefferson School of Population Health at Thomas Jefferson University and blogs at Nash on Health Policy.
Originally published in MedPage Today. Visit MedPageToday.com for more health policy news.
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{ 4 comments }
Nice article and a good read. I would add that communication between physicians and patients would improve outside the office setting if reimbursement were addressed. Usually when I read articles like email communication, twitter, etc it usually addresses privacy concerns but rarely addresses remuneration. Once that’s fixed, like lawyers charging in blocks of 15 minutes, communication will go up. Way way way up. Even during dinner. That’s what the almighty greenback does to a person.
I agree with Max. Communicating takes time away from other activities. If I were an already-super busy doctor, I wouldn’t want to spend more time outside of work communicating with patients. If there was some other exchange, like more money, or less of some other method of communication, and less of another time-taking task, I think doctors would be more likely to agree to social media communication.
Social media has good effects on both patients and doctors especially those listed in this blog, however there are also disadvantages to this scheme. Though it was found out that many patients are always hooking for information on the internet but they still trust their doctors more than the web, I’m still perplexed that someday too much use of these social media sites can affect patient doctor relationship and even the attitude of patients towards their doctors. Yeah technology is good but I do believe that everything that is too much is bad.
A very good article.
As a breast cancer survivor, I rely heavily on the discussion boards of a now nationally recognized site founded in the Philadelphia area years ago. The site evolved. As with anything else “bigger” does not translate in all aspects to “better” (IMHO). That said, the information, moral and social support from others with the same disease is priceless. Our collective voices were heard by a major pharmco who responded by changing their drug info insert to reflect side effects not previously reported. This too is priceless.
As a former health care administrator, I think as a tool for doctors to use as charted contact to patients, it may be best to retain “social” in the definition unless standardized forms can be used with area for comment. It’s enough to read the discussion boards to understand how easily perfectly sound science becomes misunderstood by patients.
If doctors tie this to reimbursement, networks need to be incorporated in the formal reporting system for patient follow-up, “dated and signed”. The anesthesia system of time, base, modifiers such as physical status, etc. comes to mind as a start of that conversation. Malpractice reform is essential for this to reach full potential (Nuisance cases could explode if this isn’t addressed.) On call support … instead of a beeper it’s an iPhone/Pad networked to an application integrated to patient charts, quality measures and tracking measures for eventual economic value standards. (Physician fraud cases could explode if this isn’t addressed.)
I use email to send my doctors research that is pertinent to my care. I don’t expect an answer immediately…they have priorities and I know their schedule. But they always respond to my questions–either at the next office or via email if they see a concern for my health. I’m in a National Health System (Italy). There is no charge for this care to the patient.
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