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Social networking impact on patients, doctors, and non-profits

David B. Nash, MD, MBA
Social media
May 6, 2010
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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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Social networking impact on patients, doctors, and non-profits
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