Healthcare and social media – forgetting the ‘social’…again?

Richard Booth is a post-graduate nursing student, instructor at McMaster University, lecturer at the University of Toronto, and the Project Lead for the Registered Nursing Association of Ontario’s (RNAO) Nursing & eHealth project.  I have known Richard for several years and we have shared information on various eHealth issues from time to time.  As we are both interested in the use of social media in healthcare, I was thrilled when Richard offered to write a guest blog post on this topic.


Over the last two years the interest in social media has become a palpable force within healthcare organizations in Canada and the world.  To date, I have been approached by three organizations interested in leveraging ‘social media’ in their clinical environments to spread their message or build awareness.  It has been from these interactions and my involvement within the informatics discipline that I’ve begun to notice a trend that is mirroring much of what I saw during the early rise of ‘eHealth’ back in the early-mid 2000s: technology first, people second.

The most commonly asked questions I receive pertaining to social media always seem to be technology focused.  There appears to be a consistent trend toward individuals wishing to implement the latest ‘buzz’ social technology, without first appreciating (or recognizing) the inherent complexities of the social environment in which the technology exists.  Worse still (and potentially more scary), I found that the majority of organizations I’ve come into contact with still do not truly appreciate the potential decentralization of power that social media imposes on the ‘owners’ of the information.  For instance, I’ve spoken with individuals who were upset that a pharmaceutical company linked to their blog/RSS feed without their permission.  This individual felt violated that information she put up on her health blog was being capitalized upon by others in a way she never intended.  My reiteration of “that’s kind of how social media works” did not do much to appease her frustration.

Equally, I’ve found that a number of healthcare organizations have truly underestimated both the potential and limitations of social media in the dissemination of health advocacy, awareness and promotion.  At this point, most of the ‘functional’ healthcare social media examples I’ve seen in Ontario have been developed in-house by technologically savvy individuals who were able to generate enough managerial/leadership support to have their visions implemented.  Similarly, some of the larger health organizations around Ontario have begun to create various social media policies that range in strength from Orwellian directives to flexible guidelines that encourage commonsense on behalf of staff/clinicians.  I’ve found these corporate social media policies to be excellent barometers of a given organization’s receptivity toward social media and their corresponding willingness to accept a decentralization of power in terms of communication with staff/consumers.  That said, there is currently significant diversity in opinions regarding the value of social media in healthcare and alignment of philosophies seems unlikely in the near future.  Since the return on investment of social media does not tend to align to traditional ‘success’ metrics, I foresee reluctance by organizations to treat social media as anything more than a playful novelty.  Hopefully time (and health consumers) will change this.  Recent examples of the power of social media during the Toronto G20 demonstrations (i.e., by the media, protestors, bystanders, and police alike) and the widely successful OldSpice viral commercials ( will undoubtedly provide a bit of reinforcement to the potential importance of this modality of communication.

In the meantime I’ve created a basic social media policy outline that I use when speaking with individuals/organizations interested in the topic.  Normally I use this framework as a vetting tool to establish some sort of common ground between an organization’s expectations and the realistic outcomes that social media might be able to provide.  I also hope this framework outlines some of my previous arguments regarding the social environment in which the social media exists – this area is all too often neglected when speaking of ‘technology’.

Finally, although I realize this model still contains some significant conceptual gaps (namely in the area of sustainability, privacy/ethics, and consumer interactivity), it has helped me begin the process of framing how social media might interact with healthcare organizations in the coming years.  Similarly, as Michael noted on an earlier draft version of this posting, the interactive potential that social media provides appears to be missing from the following model.  Therefore the current iteration of the model presents a largely one-way framework of communication using social media in healthcare – hopefully in time, and as receptivity of this modality of communication is established, a true ‘social’ mode of communication will occur between healthcare organizations and the consumers they serve.  Given some of the arguments tabled in the preceding paragraphs, true interactivity with consumers will probably be a slow evolutionary process, tempered by concerns regarding privacy and information security.  It should be an interesting process to watch unfold over the next few years.

1) What is your purpose? What is the organization’s purpose?
2) What is your demographic?
3) How does your demographic access information/content in 2010-2011, and potentially beyond?
4) What is the message you want to convey?
5) Is this message important? It needs to be important to not only you, but others who will be reading it….and potentially important to those who it wasn’t even intended to reach (e.g., politicians, news, government, vendors, business, academia).
6) Tools (this is 6th on the list on purpose….technology should never come first…the people/message should)
7) How these tools and humans work synergistically together? (this will require some experience with said tools… if you are unfamiliar with the tools and are leading the project, I would suggest highly that you start to immerse yourself quickly).
8) How do you plan to evaluate success?  Your traditional metrics will probably not give you a good idea of the penetration or success.  You’ll need to rethink what ‘success’ will be in this decentralized, largely self-evolving modality of communication.

Richard Booth

One response to “Healthcare and social media – forgetting the ‘social’…again?

  1. Pingback: Social Media for Health Professionals « The Online Journal of Nursekama

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