What is the greatest challenge associated with the use of social media in healthcare?

Tips and pointers from FutureLearn trainer on optimal use of social media for crisis management, patient engagement and preventive healthcare.

How important is it that healthcare engages in social media practice? What about social media is most challenging for healthcare organisations?

In this era of information and communication technology, every sector is taking advantage of social media, and the healthcare sector is no exception. We not only obtain information via websites, but we also interact through various social media platforms. Any organisation, such as a hospital, that aims to be in the public domain, has to use social media. Healthcare has now become patient-centred which makes patient engagement and satisfaction a top priority, hence the need to implement a social media strategy. Hospitals need social media experts—a new emerging opportunity as well as a public relations department. Employing a social media expert has become one of the necessities for many healthcare organisations.

In your FutureLearn training you cover health communication crises. How should a healthcare organisation approach crisis management with online tools? How does it differ from the approach with offline tools if at all?

In our FutureLearn course Social Media in Healthcare we look at how a hospital/healthcare organisation or healthcare authority would communicate with the mass population during the outbreak of diseases and disasters, for example SARS, Ebola, the common cold, an attack by biological warfare etc. Online tools can aid crisis management through patient engagement, education, empowerment and providing theright information, which can be carried out via social media platforms such as Twitter, Facebook and health-maps, to get information out instantly. This also enables health organisations to get the latest population insights, with regards to their own health concerns. Offline tools are more about direct implementation, treatment and other traditional strategies.

Can social media enhance healthcare crisis management or be potentially damaging?

It’s important to understand that social media has the potential to be both enhancing and damaging, during or after a crisis. There will be numerous rumours and misinformation spreading during a crisis, creating panic among the public, with the aim of making the information ‘go viral.’ Population education or empowerment is important to ensure that the general population doesn’t fall victim to such rumours. Healthcare organisations have a duty to prevent damage in this way, by creating awareness. People should be educated to distinguish between trustworthy and misleading information. For example, we published an article on how misleading information on anorexia is promoted on YouTube, stating that “the illiterate in this ICT era will not be those who cannot read and write, but those who cannot distinguish between trustworthy and misleading information available online” (Syed-Abdul et al. 2013).

What examples are there of healthcare organisations using online channels optimally (or poorly) in crisis management?

There are several healthcare organisations that use online channels during crisis management, such as the U.S. Centers for disease Control and Prevention (CDC) and the World Health Organization (WHO), the Healthcare Board etc. For example, the CDC through its Facebook page (Facebook.com/CDC) gives real- time information on crisis management, as well as prevention of ongoing epidemics and communicable diseases such as during the Ebola virus, Zika virus and dengue outbreaks. The Healthcare Board also offers a platform for discussions on health and healthcare transformation through its Facebook page.

However, poor use of online channels can lead to the population falling victim to misleading information. One such example and more information on the public health crisis during the Ebola outbreak is described by Basch et al., who looked at coverage on YouTube (Basch et al. 2015).

Your FutureLearn course covers Google trends, HealthMap, PatientsLikeMe, mobile apps, social- generated big data, research challenges and opportunities and gamification. How are these important for healthcare?

• Google trends are an essential tool to know about the insights of online search behaviour in relation to healthcare. google is a first point of call for searching online for information for any purpose, and is free, reliable and widely used by the general public; this can be used to monitor public health concerns and disease outbreaks
• HealthMap (healthmap.org) aids tracking and monitoring of real cases about a disease from all over the world. this information is useful to track ongoing trends and status of a disease and provides future insights to work on disease prevention
• PatientsLikeMe (patientslikeme.com) is a platform where patients with similar diseases share their experiences and concerns, to eventually improve the understanding of their own disease• Mobile apps are increasingly widely used, and are thus an important tool in healthcare for disease management, distraction, motivation and also communication with healthcare professionals• With the wide use of mobile phones, social media networks and websites, social-media generated big data is becoming an important and valuable resource for researchers, to explore digital epidemiology and track the health status of population

• Gamification plays an important role in health- care as it aids in distraction, engagement, motivation, as well as management in case of chronic diseases.

What are the top things that healthcare gets wrong when it comes to using social media channels?

In my understanding, ‘wrong’ here should be interpreted as being used inefficiently, because no healthcare organisation will spread incorrect information intentionally. the use of mobile phones has penetrated every aspect of people’s lives; therefore, I don’t think social media channels should be used when information is not timely or not targeted at the whole population.

How about exceptional uses of social media for healthcare marketing?

Social media can be used efficiently in several ways as a means of healthcare marketing, using sponsored ads, sharing posts in groups or with targeted audiences at the right time. For instance, we are using sponsored ads on Facebook and Google to market our app on smoking cessation and have received a good response so far, leading to more app downloads.

What needs to change in a typical healthcare marketing department to keep up with social media opportunities?

Information shared on social media reaches millions of people at the click of a button. Therefore, social media should be used as much as possible. The efficiency of the information depends on the purpose of information, time and target audience. In my opinion, social media is undoubtedly more efficient than traditional tools such as radio, television, newspapers, etc. Public engagement, as well as awareness, is important, and can help enhance opportunities in social media.

How can traditional marketing models be incorporated into healthcare social media use?
Ensure you’re reaching the right target audience with timely information, and make the information precise and easy to understand, which can be done more efficiently and more effectively by using social media.

What mix of factors make the foundation for a good social media strategy and upgrade health- care online presence?

Hospitals should be involved in social media, consistently and by posting persistently, to attract more patient followers. Regarding social media presence, awareness through various healthcare groups, stakeholders, marketing ads, pages, tweets, etc. can be used for promoting the hospital’s activity.

If a healthcare organisation asks your advice on how to approach social media, what are your top three pointers?

1. Focus on preventive care: In the case of a healthcare organisation, I would suggest creating promotional activities to attract more of their target audience on social media. Awareness of digital health literacy is relevant here, as it relates to people’s ability to find useful health information, difficulties faced by web users, and how to improve e-health literacy among citizens (Atique et al. 2016).2. Focus on patient engagement and satisfaction.3. Use social media for creating disease-focused groups.Social Media in Healthcare: Opportunities and Challenges, is available on the FutureLearn social learning platform on 14th May 2018 - see https://iii.hm/h62

Key points

Social media needs to reach the right target audience with timely information
Information should be precise and easy to understand
Social media should focus on preventive care, patient engagement and satisfaction and disease groups
Social media has the potential to be both enhancing and damaging
People should be educated to distinguish between trustworthy and misleading information available online

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From: Social media use in healthcare: A systematic review of effects on patients and on their relationship with healthcare professionals

Year	Author(s) - Article no.	Journal	Main objective of study	Type of research	Data collection	Participants (sample)
2005	[13]	Journal of Sociology	To explore the experiences of, and attitudes towards, online support groups	Qualitative	Interviews	33 Australian men with prostate cancer and 18 specialists
2008	[22]	Journal of Medical Internet Research	To explore whether lurkers in online patient support groups profit to the same extent as posters do	Quantitative	Online survey	528 members of Dutch online support groups for patients with breast cancer, fibromyalgia, and arthritis
2008	[28]	Journal of Medical Internet Research	To identify and analyse how users of the platform PatientsLikeMe reference personal health information within patient-to-patient dialogues	Qualitative	Analysis of comments	123 comments posted within the ALS community
2010	[15]	New Review of Hypermedia & Multimedia	To understand why and how people use health-related sites	Quantitative	Online survey	33 Patients with a medical condition (patients)
2010	[27]	Pedriatic Transplantation	To investigate the feasibility and safety of an online virtual community as a potential psychosocial intervention for post-transplant adolescents	Qualitative and Quantitative	Data analysis of the Zora system logs and interviews	22 patients with solid organ transplants aged between 11-15 years
2010	[35]	Journal of Psychosomatic Obstetrics & Gynecology	To focus on investigating the perceived disadvantages of online infertility support communities from the perspective of those who access and participate in them	Qualitative and Quantitative	Online survey	295 participants coping with fertility problems
2010	[36].	Journal of Medical Internet Research	To describe the potential benefits of PatientsLikeMe in terms of treatment decisions, symptom management, clinical management, and outcomes	Quantitative	Online survey	1323 members from six PatientsLikeMe communities (ALS, MS, Parkinson’s Disease, HIV, fibromyalgia, and mood disorders)
2011	[23]	Patient Education and Counseling	To investigate the potential of online support groups to foster empowerment and how membership might affect the patient/health professional relationship	Quantitative	Online survey	246 individuals from 33 chronic conditions online support groups
2011	[26]	Journal of Medical Internet Research	To explore the differences in peer support received by lurkers and posters in online breast cancer communities	Quantitative	Online survey	253 members of four Japanese online breast cancer communities
2012	[16]	Journal of Medical Internet research	To explore the motivations and challenges faced by patients who share videos about their health and experiences on YouTube	Qualitative	Analysis of videos	Videos uploaded by 4 patients with a chronic condition
2012	[30]	Health Communication	To examine the indirect effect of Computer Mediated Social Support on doctor–patient communication through utilizing the sense of empowerment	Quantitative	Online survey	464 Korean patients with diabetes
2012	[38]	Information Research	To examine the use of an online health forum by married Korean women living in the USA who sought help for health and medical issues	Qualitative	Content analysis of posts	1000 messages posted to a health forum MissyUSA
2013	[14]	International Journal of Medical Informatics	To investigate whether communication in online patient support groups is a source of individual as well as collective empowerment or to be understood within the tradition of compliance	Qualitative	Analysis of posts	4301 posts from two online communities, one for patients with COPD and one for women with pregnancy problems
2013	[24]	Journal of Health Psychology	To explore how cancer patients’ writing and reading on the Internet play a role in their conditions experience	Qualitative	Focus-group interviews	34 Cancer patients
2013	[25]	JRSM short reports	To explore how participation in an online support community may impact upon the experience of inflammatory bowel disease	Qualitative and Quantitative	Online survey	249 patients living with either Crohn’s Disease (65.9 %) or Ulcerative Colitis (26.1 %) or awaiting formal diagnosis (8 %)
2013	[34]	Nordic Journal of Psychiatry	To evaluate if and how online self-help forums are used by patients with bipolar disorders, their relatives and treating professionals	Qualitative and Quantitative	Content analysis of posts	2400 postings of 218 users (Patients with Bipolar Disorder (94 %), Relatives (4 %), or Professionals (2 %))
2014	[1]	Patient Education & Counseling	To explore how individuals use online health community content in clinical discussions and how healthcare providers react to it	Qualitative	Focus groups	89 members of an online health community
2014	[17]	Obstetrics & Gynecology	To determine whether social media, specifically Facebook, is an effective tool for improving contraceptive knowledge	Quantitative	Survey	143 Patients who had scheduled a routine visit to a gynaecologist
2014	[21]	Indian Journal of Psychological Medicine	To explore the potentials of social networking sites as an adjunctive treatment modality for initiating treatment contact as well as for managing psychological problems	Qualitative and Quantitative	Interviews and an online survey	28 patients with any of the depressive or anxiety spectrum disorder
2014	[37]	Reproductive Health	To use the online platform of blogs to explore whether the framing effect of information content, situated learning of information content, and health knowledge involvement would affect health communication between doctors and patients and further explore whether this would increase patient willingness to seek treatment	Quantitative	Online survey	278 participants who were seeking medical treatment in a clinic or hospital in Taiwan
2014	[39]	Journal of the American Medical Informatics Association	To describe adults who use Twitter during a weight loss attempt and to compare the positive and negative social influences they experience from their offline friends, online friends, and family members	Qualitative and Quantitative	Survey	100 participants trying to lose weight
2016	[40]	Counselling Psychology Quarterly	To test for differences between offline and online psychological disclosure in case of young adults	Quantitative	Survey	128 young adults attending individual psychotherapy.