Health 2.0—Lessons Learned

Abstract

The advent of social networking as a major platform for human interaction has introduced a new dimension into the physician–patient relationship, known as Health 2.0. The concept of Health 2.0 is young and evolving; so far, it has meant the use of social media by health professionals and patients to personalize health care and promote health education. Social networking sites like Facebook and Twitter offer promising platforms for health care providers to engage patients. Despite the vast potential of Health 2.0, usage by health providers remains relatively low. Using a pilot study as an example, this commentary reviews the ways in which physicians can effectively harness the power of social networking to meaningfully engage their patients in primary prevention.

Introduction

The advent of social networking as a major platform for human interaction has introduced a new dimension into the physician–patient relationship, known as Health 2.0. The concept of Health 2.0 is young and evolving; so far, it has meant the use of social media by health professionals and patients to personalize health care and promote health education.^1,2 Social networking sites like Facebook and Twitter offer promising platforms for health care providers to engage patients in primary prevention. Despite the vast potential of Health 2.0 to engage patients,^3,4 usage by health providers remains relatively low. This begs the question, “What is holding us back?” Part of the answer lies in the lack of evidence-based consensus guidelines on how to integrate social networking into health systems. Few research studies examine the effective use of Health 2.0 platforms by providers to communicate and motivate patients. ⁵

Our Study

At our institution, we faced these challenges firsthand as we created public Facebook and Twitter web pages in 2011 to connect with our patients. Our web pages feature daily postings on practical tips for healthy behaviors, educational posts on common illnesses, and recent research discoveries. In the past year, we initiated a vaccination campaign on these pages, where we posted biweekly Facebook and Twitter flu-shot reminders, in an attempt to increase patient uptake of influenza immunization.

Our attempt to quantify the success of this campaign on impacting vaccination behavior was limited by small sample sizes and methodological difficulties brought on by the anonymous nature of social networking sites. As privacy policies restrict access to users’ personal information, it became impossible to identify which followers of our Facebook and Twitter web pages were actually patients of our clinic. Given this limitation, a case–control study design was not feasible and we opted for a cross-sectional survey instead. We polled eligible clinic patients on the impact of the newly implemented web pages on their decision to receive the influenza vaccine.

Eligible patients completed a self-administered cross-sectional survey during the 2011-2012 flu season. The 10-item survey collected data on sociodemographics, Internet usage, social networking habits, and reason for vaccination (the clinic’s Facebook and Twitter reminders being one of the options). In all, 52 participants completed the survey (overall response rate 76.5%). Half the respondents used Facebook and/or Twitter. 16.3% of respondents used the clinic’s Facebook page, 9.6% of respondents used the clinic’s Twitter page, and 13.5% of respondents received their vaccine due to the clinic’s social networking reminders. No statistically significant differences were found between those who did and did not use the social networking reminders with respect to age (P = .71), sex (P = .44), education (P = .22), and hours spent on Internet (P = .21).

Although this pilot project showed that online health reminders motivated vaccination behavior among a proportion of study participants, the sample size was too small to demonstrate a clear relationship between use of social networking reminders and increased vaccination rates. Despite this outcome, we learned valuable lessons on how to network with patients online for health education.

Lessons Learned

Have a Clear Goal

Avoid trying to do too much with your web page, especially when starting out. In our experience, we used our Facebook and Twitter web pages to achieve multiple aims: to raise funds, to disseminate health education, and to promote preventative health behaviors. By diluting the focus of the web pages in this way, it was difficult to engage patients in any one activity. Health-related social media can be used in a variety of ways, including but not limited to, providing a forum for patients to ask questions, surveying patients about their health needs, and sharing information specific to a practice. With endless possibilities, it is essential to identify the main objectives of your web page.

Focus on a Target Population

Be it youth, the elderly, or the underserved, different communication strategies work best for different demographic groups. Know who you want to target and research the demographics of that population. This will allow you to tailor the content of your posts, and the means in which you distribute it, to the right audience. Content that is targeted appropriately is more likely to resonate with users and spread virally.

Engage Patients Meaningfully

Given the steady stream of content that bombards social media users, the key to connecting with patients online lies in building a dependable relationship, similar to your offline professional relationships with patients. If users can rely on a web page to provide relevant and accurate information that addresses their needs, they are more likely to buy-in. For this to occur, health care providers must allow for two-way communication on their web pages, so that they can receive real-time feedback on the utility of the content that they are posting. This may take the form of allowing patients to post comments, ask questions, or participate in polls on the web page. In our experience with health-related social media, patients understood that websites are inappropriate forums to discuss their personal health information. Nevertheless, to protect confidentiality, it is important to regularly monitor your web pages and remove private information that violates the terms of use you have established for your patients and/or those of the social media platform you are using.

Use Interactive Ways to Deliver Your Content

Social networking sites provide myriad opportunities to engage patients through polls, events, liking functions, videos, applications, and more. Incorporating multiple forms of media to deliver content is useful in ensuring key messages are absorbed.

Work With an Intermediary

Physicians must play an integral role in generating content and participating in discussions on social networking sites to ensure that health-related messages are accurate. For instance, a Pew Internet Report found that nearly three quarters of patients did not consistently check the sources of the online health information they were accessing. ⁶ The maintenance of an up-to-date and evidence-based site requires an equally high level of time and commitment. To help reduce the workload on physicians, we worked with a third-party marketing company, who helped us develop and publish posts on the web pages with direction from our physicians.

Conclusion

The potential of social networking to actively and meaningfully engage patients cannot be ignored. While there is tremendous demand for healthcare providers to connect with patients online, ⁷ physicians are poorly equipped to meet their patients in this new arena of interaction. Much of the established research on Health 2.0 highlights the experiences of healthcare providers and patients online, as opposed to measuring the success of social networking interventions on directly improving health indicators. There is a need to broaden the research focus to investigate the use of Health 2.0 by physicians to effectively engage their patients. In particular, we are interested in using social networking to increase preventive health behaviors among our patients. We hope our experience will help others run more effective health promotion campaigns and encourage further study within this area.