Majority of healthcare professionals have personal social media account(s) nowadays. None of them, use their personal accounts to engage patients online. These I learned after asking workshop participants’ if they use social media to engage patients online.
Here are the important points I learned from the participants and workshop I gave on Establishing Social Media Presence at the 1st SKMS Post Graduate Course in St. Louis Hospital last February 17, 2018 :
There’s an increasing number of patients going to the internet and social media to seek health information, join support groups and share their healthcare experiences.
Majority of healthcare professionals are on social media to update on medical healthcare news, share information or join colleagues in support groups.
Healthcare professionals don’t use their personal social media accounts to engage patients online.
There is confusion as to the benefits of using social media in healthcare.
There is some degree of confusion on how should healthcare professionals (or healthcare institutions) respond when they are tagged in a social media posts.
I cited several, global and ASEAN studies to support points number 1 and 2. None of the workshop participants (around 300+ of them) raised their hands when I asked if any of them is using social media to engage patients online. I have no current local study to validate or refute this, so I’ll take point number 3 until proven otherwise. I discussed the benefits of using a professional social media account to protect one’s reputation online and leave a positive digital footprint to impact healthcare.
For those interested, I will be posting my slides at my Slideshare/ LinkedIn account soon. Please visit my profile there.
References:
Patdu, Ivy. Recommendations for Social Media Use in Hospitals and Health Care Facilities. Philippine Journal of Otolaryngology Head and Neck Surgery, North America, 31, jun. 2016
Marie Ennis-O’Connor (2017). Social Media: A New Dimension In Health Research [PowerPoint slides]. Retrieved from https://www.slideshare.net/ennoconn/social-media-a-new-dimension-in-health-research
Pei-Li Teh & Marc Yates. 2013. Digital Health in Asia. Issue no. 4. Research Partnership. Available at https://www.researchpartnership.com/media/1182/free-thinking-digital-research-in-asia.pd
Warden, Christopher. 2017 Referral MD. www.getreferralmd.com. Accessed at https://getreferralmd.com/2017/01/30-facts-statistics-on-social-media-and-healthcare/
The Healthcare Social Media Shakeup. CDW Healthcare. Accessed http://www.cdwcommunit.com/resources/infographic/social-media/Massachusetts Medical Society Social Media Guide. 2015 http://www.massmed.org/Governance-and-Leadership/Committees,-Task-Forces-and-Sections/MMS-Physicians–Guide-to-Social-Media-(pdf)/
Gholami-Kordkheili F, Wild V, Strech D: The Impact of Social Media on Medical Professionalism: A Systematic Qualitative Review of Challenges and Opportunities J Med Internet Res 2013;15(8):e184
Chua, ER , Calderon, PE . Ethico-Moral Responsibilities of Health Care Practitioners on Social Media. Proceedings of the DLSU Research Congress Vol 4 2016. March 7-9, 2016
Isip-Tan, Iris Thiele (2014). Establishing a Professional Social Media Presence [PowerPoint slides]. Retrieved from https://www.slideshare.net/isiptan/establishing-a-professional-social-media-presence-86320762
Advocates has long championed social media as a tool for patient education in healthcare. Social media was taunted to increase meaningful patient engagements, an increase health practitioners’ and patient collaborations that would result to improvements in the various facets of healthcare- from physician-patient relationships, quality point of care to increase in surveillance of less familiar but equality important health disease and issues. The use of social media for health education also enabled patient’s (or his / her support community) navigate a complex rapidly changing health system and thus improve his or her quality of life.
Patient health education via social media needed a critical reflection however. Although there are studies looking at its effect as a tool for health learning, the results are quite inconclusive. Is it the methods of teaching? The target learner? Or are the the metrics used? There seem to be a confusion on what constitute an effective social media tool for health learning in the general populace.
From an educators standpoint, the use social media as a tool for learning is a characteristic of connectivist pedagogy of teaching and learning. This theory came about as a result of rapidly changing, many-to-many type of communication and web 2.0 (social media) technologies. If social media is to be effectively used as a tool for teaching and learning of patients in healthcare, one must learn the nuance of this pedagogy and the context of what a typical (Filipino) health learner is. Also, such learning does and goes beyond formal traditional, institutional learning that we knew and have gone through. This author believe, such belong to lifelong learning and is a must learn for healthcare educators to be effective.
Or, we get fake news, misinformation and worst harm patients and the general public with its inappropriate use
In this chat,#HealthXPh will discuss health educational technologies and designs with educational healthcare social media pioneers to find that appropriate method of using social media as a tool for health education. Thus, the objectives of this discussion/chat are
(1) Characterise what constitute typical (Filipino) health learner that are probably receptive to social media as a tool for healthcare learning.
(2)Identify educational designs (or pedagogies) of teaching and learning that are appropriate for patient education in the context of health.
(3) Give example of patient learner education design that you ( or someone you know) effectively applied in practice.
The following are the guide questions for our chat:
T1. What characterize a typical health learner that is receptive to social media as a tool for learning?
T2. What teaching and learning strategy that uses social media as tool is most apt for this typical health learner?
T3. Give a health teaching strategy using social media that you have applied to practice? What were the results?
I am aware that objectives and question number one are often labelled as stereotyping. For most educators, contextualizing learning to a particular set of learners is a must to be effective. Thats all there is to “characterising learners” in education.
Join us later 9:00 PM Manila time as #HealthXPh listens to experts as we discuss patient health education via social media!
Mrs. H is a 54 year old single parent of four and a volunteer rural health worker in a community. She logs in before seven at the baranggay health station, checks her tasks for the day, then proceed checking the families she has worked with the past days. Her daily routine consist of home visits, doing health teaching and family counselling until five in the afternoon. Then Mrs H goes back to the health station to do a quick summing up meeting with fellow volunteers and get home before 7 PM. Mrs. H has been doing this for 20 + years, surviving on community donations to run the rural health unit. “I am happy for the opportunity to help my community.” she said. As the community health indicators- maternal and infant mortality rates and malnutrition improved, the ranks of community health workers like Mrs. H dwindled. At the age of 65, Mrs. H had hypertension, type II diabetes, survived two cancer surgeries and had a string of hospital admissions from countless systemic and infectious diseases. After surviving each of these personal struggles, her lament is still ” I wish I could get out of this sickbed and do more!”
There’s a self assessment tool by Adam Grant to help identify if you are a giver or taker. That’s a self assessment tool though. How would you identify a giver in your health team?
T1: What’s your best qauge for identifying a giver?
Dr. N graduated at the top of his class and trained in one prestigious center for his specialty. He went back to his home province and built one of the most caring physician practice ever built around the area. He sees patients the whole day and is known to revisit admitted patients at night before going home. He instructs floor nurses to call him anytime, for any updates on his patients. He refuses any other engagements if it meant leaving his patients behind. ” I just want to give patients the care they deserved. That is the standard right?” he once told a colleague. Dr. N also made it his personal advocacy to help care givers survive a health system filled with stress and grief. One night Dr. N collapsed inside his apartment’s bathroom and suffered a myocardial infarction. A colleague noticed he wasn’t answering calls and sent a hospital’s emergency response team to his apartment. He survived that event and slowed down for a while in his practice.
T2. How would you cultivate an environment supportive of a giver?
“Code! Bed 4!” The floor nurse just called. The ward team on duty sprang into action, initiating ACLS with clockwork precision and reviving B4 within minutes from the call. Besides patient Bed 4 is a grief stricken and apologetic Ms. R, the 45 year old companion of patient bed 4. “I’m sorry doctor, I fell asleep”. Ms. R has been manually “ambubagging” patient B4 for more than 24 hours already. “My husband drives a pedicab to earn and take cares of our 4 children. My siblings went home to raise money for my father’s hospitalization. I left my work as a house help to take care of my father”. Unfortunately Mrs. R husband left her and their kids. She had to take care of her dad and left her children with their neighbours. “At least I still have my dad and children.” She told me. Not a single word came out of my mouth…
T3. How would you avoid or resolve giver fatigue in your team?
Mrs. H, Dr. N and Ms R are examples of what many call “givers”. Givers help institutions, communities or families thrive, in the long run. The healthcare industry is full of giver stories that exemplifies the caring and giving characteristic of the profession. Whatever motivate givers is the subject of studies nowadays but for the most part, it is virtually unknown. Motivation is also the least of giver’s concern. Most givers are so consumed by the act of giving even their personal lives suffer in the short run.
Since givers are desirable part of any team, how do we help them thrive in the healthcare environment? Join #HealthXPh chat this Saturday November 25, 2017 9PM Manila Time to discuss ways on helping givers thrive in the healthcare industry. Here are our guide questions for the chat:
T1: What’s your best qauge for identifying a giver?
T2: How would you cultivate an environment supportive of a giver?
T3: How would you avoid or resolve giver fatigue in your team?
Majority of adult Americans get their news from social media according to a recent 2016 Pew Research Center study. Roughly two thirds of Facebook users get their news on this social networking site, which translates to 44% of the US general population. Forty two percent of US consumers used social media to assist in their healthcare decision making decisions. The proliferation of fake news however has sowed confusion among 63% of adult population on social media. Health and health care wasn’t spared from fake news proliferation.
In this discussion, we hope to raise your awareness on fake health news, learn how to spot fake health news online and advocate sharing of tips on spotting fake health news to the general population. Specifically,
to reflect on why (or why not) fake health news on social media is a problem
to enumerate ways on spotting fake health news on social media
to identify the ways in which social media companies combat fake health news
to enumerate way how healthcare professionals should address fake health news on social media.
Fake news or post truths are “type of propaganda that consists of deliberate misinformation or hoaxes spread via traditional print and broadcast news media or online social media”. It is intentionally written and published to mislead people for financial or political gains. Fake news often have “sensationalist, exaggerated, or patently false headlines” to grab the reader’s attention.
Activity 1. Test your fake news knowledge by answering this BBC Quiz on spotting fake news. A number of quiz items refer to fake health information online.
Social Media as a source of trustworthy news
Approximately 62% of US adults get their news from social media sites such as Facebook and twitter.
Percentage of US adults who get news from social media networking sites (Source: Pew Internet Research Group)
This is a significant increase compared to a 2012 study, which says that 49% of US adults seek news on social media sites. Interestingly a 2012 pWC Health Research Institute study showed 42% of consumers have used social media to access health-related consumer reviews and assist in their healthcare making decisions.
Not only are US adults getting their news on social media or that social media information influences their healthcare decision making but the trust ratings for health information on social networking sites are high. A 2016 architectural approach study revealed that users perception of health information on social media is high. This confirms an older 2012 pWC study that revealed 90% of respondents age 18-24 would trust information shared by others on social networking sites.
Recently, the proliferation of fake news online has sowed confusion among social media users. About two-in-three U.S. adults (64%) say fabricated news stories cause a great deal of confusion about the basic facts of current issues and events. Fake news and the confusion it brings is even more dangerous and potentially damaging in healthcare. One of the most shared health news on Facebook is fake health information. Can you spot this popular health misinformation?
Are fake health news on social media a problem?
A recent Independent (UK) article stated “how dangerous fake health news has conquered Facebook” postulating that “misinformation published by conspiracy sites about serious health conditions is often shared more widely than evidence-based reports from reputable news organisations”. Half of the 20 most shared news bearing the word “cancer” in its headline seen by a combined total of millions in 2016 were discredited by health authorities and are considered myths or fake news. The worst part of this cancer fake health news is that it is dangerously misleading.
In what ways could social media companies combat fake health news?
How should healthcare professionals address fake health news on social media?
There are a few health institutions and professionals who seek out and debunk fake health news on social media. Cancer Research UK and Sense About Science are two of these institutions but fake health news continues to proliferate online. Admittedly, not many healthcare professionals debunk (or at least voicing out their concern) fake health news on social media. This is one of the reasons why fake health news still proliferate online.
Activity 2. Using your twitter handle (eg. @bonedoc), join the #HealthXPh chat on twitter this Saturday September 30, 2017 9:00- 10:00 PM Manila time and reflect on the following guide questions
T1: Is fake health news on social media a problem? Why or why not?
T2: In what ways could social media companies combat fake health news?
T3: How should healthcare professionals address fake health news on social media?
Send your reflections with the hashtag “#HealthXPh” anywhere inside your 140 character length tweets. Multiple tweets allowed so long as it is within the one hour time frame set by the moderator. Expect retweets and tweet-discussion with global participants.
Activity 3. Using this guide, retest your fake news knowledge by answering this BBC Quiz on spotting fake news. Share your experience on this discussion by appending your thoughts/ summary on the header of this image and posting it on your social media networks.
Summary:
In this learning discussion, we raised your awareness on fake health information on social media, did activities to spot and debunk fake health news on social media and shared your thoughts on combating the proliferation of fake health news via social media twitter and facebook. #HealthXPh hopes that healthcare professional would play an active role in combating fake health news online.
References:
Gottfried, Jeffrey and Shearer, Elisa ; Pew Research Center, May, 2016, “News Use Across Social Media Platforms 2016” Retrieved Sept 30, 2017 http://assets.pewresearch.org/wp-content/uploads/sites/13/2016/05/PJ_2016.05.26_social-media-and-news_FINAL-1.pdf
Health Research Institute April 2012; Social media “likes” healthcare From marketing to social business Retrieved Sept 30, 2017 http://www.pwc.com/us/en/health-industries/health-research-institute/publications/pdf/health-care-social-media-report.pdf
Lopez, D.M., Blobel, B. & Gonzalez, C.; Information quality in healthcare social media – an architectural approach; Health Technol. (2016) 6: 17. Accessed Sept 30, 2017 https://doi.org/10.1007/s12553-016-0131-9
Andrew Griffin, Rachel Roberts; Facebook’s plan to stop fake news revealed by Mark Zuckerberg, but site will continue to promote stories it knows to be fake. Independent (UK) ; 15 December 2016 18:59 GMT Accessed Sept 30, 2017 http://www.independent.co.uk/news/uk/politics/facebooks-plan-to-stop-fake-news-revealed-by-mark-zuckerberg-facebook-changes-what-are-they-fake-a7478071.html
Childs, Oliver Don’t believe the hype – 10 persistent cancer myths debunked Science Blog in Cancer Research UK March 24, 2014 Accessed Sept 30, 2017 http://scienceblog.cancerresearchuk.org/2014/03/24/dont-believe-the-hype-10-persistent-cancer-myths-debunked/
The lack or ineffective social marketing strategy (supply side barrier) and lack of information on benefits and availment process (demand side barrier) are a few of the identified restrictions to the use of health services in complex decentralised health systems such as the Philippines.
The Department of Health (DOH) is the lead agency responsible for the regulation and supervision of the country’s health system. It manages national policies, develops national plans and establishes health technical standards and guidelines to regulate the country’s health sector.
The Local Government Code of 1991 devolved the provision of health services, particularly at the primary and secondary levels, through the local government units (LGUs). Hence, health service in the Philippines is managed through provincial, municipal and barangay local government offices. Provincial and district hospitals are the responsibility of provincial governments while the Rural Health Units (RHUs) and Barangay Health Stations (BHS) are managed by municipal government units.
Complex internal developmental differences among geopolitical regions hamper provisions of health two decades after the implementation of the local government code. Less developed regions usually suffers most of the negative effects of institutional fragmentation. These least developed regions also is the least likely to recover or lags behind because it lack or poorly manages resources and is usually inefficient in allocating health resources.
Cetrángolo et al identified supply and demand side barriers that restrict the use of health provisions in the Philippines. The lack or ineffective social marketing strategy and lack of information on benefits availment process are included in these restrictions. Grundy’s echoed the same observations in a local study.
This author has practiced for more than ten years in areas with health units ran by local governments and in urban center with health institutions ran by DOH. While there are LGUs with efficient and effective local health councils who clearly benefitted from the devolution of health, other regions aren’t as fortunate. Case in point, the WHO Safe Surgical Checklist.
The WHO Safe Surgical Checklist 2009
The WHO Safe Surgical Checklistis the single most cost effective way of minimising post operative complications reducing death and morbidity by at least 36% on the average. No other cheap, readily and sustainably implementable guideline (except maybe the handwashing guide) had so much impact on health as this checklist. It has been incorporated into standard DOH standards operating room “toolset”, requiring every hospitals with operating rooms to incorporate such checklist in their standard operating room manuals. Yet many hospitals who have operating rooms rarely take advantage of this readily available and cheap guideline. Why is that?
Cognisant of these complex problems, efforts has been made in the past two decades to either strengthen or amend the local government code that devolved health provisions to LGUs. Bills calling for returning provisions of health back to the national lead agency (DOH) are now pending in the House of Representatives. It is not the purpose of this article to weigh the complex pros and cons of such amendments. Until such amendments or repeals are enacted into law, we have to deal with effectively delivering health down to grassroots level in the context of a decentralised health system.
An effective social media campaign may narrow regional differences in the provisions of health and address the two barriers I mentioned at the start of this article.
Join #HealthXPh this Saturday August 26, 2017 9pm Manila time as we discuss how a social media campaign may improve provisions of health in the context of a devolved health and regional developmental differences.
T1. Is there a role for social media as social marketing strategy for effective provisions of health in a decentralised health system?
T2. If you are the chief social media strategist what will your primary strategy be?Targeted? Regional? National?
T3. How would you measure the effectiveness of such healthcare social media strategy? Indicators?
Please give your final thoughts on ways by which social media could be a part (or not) of the social marketing strategy for health units or agencies in a decentralised health system like the Philippines.
References:
Cetrángolo,O., Mesa-Lago,C., Lazaro,G., Carisma,S. Health Care in the Philippines: Challenges and Ways Forward. 2013
Grundy J1, Healy V, Gorgolon L, Sandig E. Overview of devolution of health services in the Philippines. Rural Remote Health. 2003 Jul-Sep;3(2):220. Epub 2003 Jul 1.
Haynes, A.B., Weiser, T.G., Berry, W.R., Lipsitz, S.R., Breizat, A.H.S., Dellinger, E.P., Herbosa, T., Joseph, S., Kibatala, P.L., Lapitan, M.C.M., Merry, A.F.: A surgical safety checklist to reduce morbidity and mortality in a global population. N. Engl. J. Med. 360(5), 491–499 (2009)
Atienza, Maria Ela L. 2004. “The Politics of Health Devolution in the Philippines: Experiences of Municipalities in a Devolved Set-up.” Philippine Political Science Journal 25 (48): 25–54.10.1080/01154451.2004.9754256
