Abstract- Significant development has been realized in healthcare domain in recent years. This development drives the healthcare domain into a very highly innovative area of research.
With the advent of Health 2.0
1 , healthcare has become the most focused area for the research community to bring innovations using the emerging technologies. Social media is one of these technologies that have changed the lifestyles of people through the interaction with computing systems. Social Media is becoming part of our lives and we used to interact with it more vigorously these days. Facebook is a kind of social media and its users are increasing day by day. Twitter, YouTube and Wikipedia are the other most common examples of social media that community is involving largely to use for various objectives. Similarly, a number of medical knowledge e-resources like Medmapia are also available and can be used to get important information for clinical decision making or for building pre-knowledge before treatment.
All these examples are successful in their own. The question is how to properly utilize them in healthcare domain so that both patients and physicians feel the difference in their lifestyles?
Healthcare domain is being considered as one of the strong candidates for social media participation. A lot has been written on this topic but no clear idea has emerged yet. This work identifies some key requirements for the design of social media participated healthcare system and the challenges to address these requirements. This work is a step towards establishing an environment for both patients and physicians to interact with each other in easy, speedy and cost-effective way by reducing unnecessary physical meetings. Patients can view/share experience with other patients having the kind disease. Physicians can benefit from experience of other physicians for some chronic decease diagnosis. Also this work can play significant role towards achieving the Millennium Development Goal (MDG) specifically the MDG 6 “To combat HIV/AIDS, malaria, and other diseases”. and different clinical knowledge e-resources to a healthcare system. Such kind of linkage will ultimately result in costeffective solution for both patients in getting care and providers in providing care. The result of collaboration among physicians upon some critical situation of patient treatment can be used as an evidence for CDSS (Clinical Decision Support
System) [3]. However, all these efforts will not be without risk because it involves security and privacy of information [2].
One important aspect of this work is achieving interoperability.
HL7 is the community leading standard in the domain of healthcare information exchange and interoperability domain and HL7 V3 [4] is the latest standard available claims at providing true semantic interoperability. The aim of this paper is basically to identify the requirements and the challenges for the envisioned system. The result will be an interactive and federated environment within a clinical information system available at right time for patients and providers to get benefit from. This idea will add the power of social media to healthcare information systems. It will bring facilitation in term of self-assessment and medication for patients and physicians respectively.
II.
L ITERATURE REVIEW
Web 2.0 is changing the nature of communication and social networks by introducing innovative social technologies. It gives new healthcare model and opportunities available for the community via tools like Facebook and Twitter [5]. 61% of adults look online for health information and 20% of those adults, or "e-patients," have actively contributed to online health discussions - from posting comments or information
I.
I NTRODUCTION
Social media can be defined as communications using online technologies to share opinions, insights, experiences and perspectives with each other [1]. Healthcare like other industries needs social media to use for better patient care.
According to [2] Social media has invaded healthcare from at least three fronts: innovative startups, patient communities and medical centers. This work provides solutions of how to canonicalize social media meaningfully establishing communication between patients-physicians and physiciansphysicians. By Canonicalization of social media we mean a consolidated linkage and customized integration of social media like Twitter, YouTube, Facebook, Wikis, Forums, Blogs
1 Health 2.0 is a popular term emerged from the word of Web
2.0. Social media presence on internet termed the conventional
Web into Web 2.0. about health on blogs or forums, to sharing photos or videos about health issues to reviewing doctors and hospitals [6]. A number of ways are possible that social media can help promoting good health. According to [7], we can benefit from social media in five ways. Various websites are placed on
Internet providing information about symptoms, environment conditions, source of infections etc. People voluntarily share such data via online forums as a great source of useful information. Privacy is a hot consideration for such kind of sharing of patient data unlike use of healthcare system within territory of hospital or laboratory where tight privacy measures are taken place. PatientLikeMe [8] is one of the most empowering places for patients to check other patients suffering from the same diseases. Social Medias like Twitter can connect patients to physicians. We cannot ignore the importance of tweets of physicians, patients but at the same time how we can convince the physicians to use this new

technology because they are already over burdened. With the help of twitter we can find tweets by physicians in the range of patient who is interested to search for a specific disease. Hello
Health [9] is web-based software provides platform to patients finding a doctor for appointments. Physicians are registered to this system and involve in business by putting their rates. The focus is how to make community information as useful as other data for example weather data. Community is struggling towards this challenge. One example we can find is Health 2.0
Developer Challenge [10]. Wikis are comparatively old form of social media compared to Twitter, Facebook etc. However they can play a vital role in collecting healthcare information.
Conventional healthcare application works on transactions only not on contents. It is time to bring contents close to the transactions used for various operations. Medmapia [11] is very good example in this area. Communities already established through twitter, facebook or myspace can easily be utilized to work on open source tools and application. Connect
[12] is very good example of community open source healthcare system.
Systems mentioned in this study are lacking in one feature or in another. For example, PatientLikeMe [6] provides the information for patients to check patients affected from the kind decease. Hello Health [7] is specialized for doctor appointments. Similarly Medmapia [9] is featured to bring contents required by a particular transaction. All of these are very good solutions but they are lacking to provide a coherent use of social media at one place. Second most obvious measure is the lack of interoperability. Third they don’t tell about how social media collaboration results can be used in CDSS.
Although Infobuttons [13] [14] provides solution to connect physicians with medical knowledge e-resources based on context-aware requests but it does not tell about how to facilitate the patients with this information. Similarly, it focuses only on knowledge e-recourses not on the other social media. We are envisioned to create an interactive environment for the users of healthcare information systems to get advantage of the social media in the process of care.
III.
R EQUIREMENTS AND C HALLENGES
Social Media canonicalization in healthcare is not that trivial to consider. This is a many-fold consideration process having diverse requirements to consider before deciding of implementing the system. Some of the critical requirements with associated challenges are discussed as follows;
A.
Scope
Healthcare is a vast domain and information systems developed for it are having different scope starts from personal health to public health. According to [15], healthcare is divided into three spheres; Personal Sphere,
Clinical Sphere and Population Sphere. Personal sphere is related to individual health. Clinical sphere is related to practitioners and biomedical experts to collaborate on individual cases for better treatment. Population sphere is made of public health officials and community with the objective to implement best practices and policies.
Challenge(s): a.
Will one solution work for all spheres or it will require a separate solution to deal with each sphere? b.
What kind of user interface to provide as the interface for each sphere should different from the other due to the fact of users’ variations?
B.
Tools and Technologies
A number of tools and techniques are available to use for social participation in healthcare. On one hand, technologies are meant to enhance the human capabilities
[16] but on the other hand, their wrong selection might leads to a sort of least effective solution.
Challenge(s): a.
Selection of tools and techniques based on the criteria to support each other rather to oppose is a true challenge. b.
Wrong selection can affect the performance and flexibility of the system to support futuristic techniques.
C.
People
A number of people with different backgrounds will be part of using or contributing to social mediated healthcare system.
Challenge(s): a.
How to deal with the knowledge of people in useful way? b.
Look and feel for physician is not necessary to be the same as that for patients.
D.
Information Scrutiny and validity
Involving community including physicians, patients and policy makers may create cloudy environment with respect to information. This is difficult to differentiate between valid and invalid information.
Challenge(s): a.
Who will scrutinize and verify the validity of information before it can be used for medication? b.
The information only can mislead the population.
E.
Information Exchange and Interoperability
Information is any way required to share among various stakeholders. Patients will send message requests to doctors for appointments. Physicians will be involved to share information with his/her patients on various diseases.
Without using standard way of information sharing might result in ambiguities and information mishandling or misinterpretation.
Challenge(s): a.
What standard to choose? b.
If we decide to choose some standard it requires reviewing if there is any specifications are in hand for social mediated information exchange.
Infobuttons is a very good solution to

IV.
a.
communicate with health related knowledge eresources based on HL7 standard. But the question is big here. We are designing a framework where not only required of how to access the information buried in knowledge resources rather we need to support meaningful dissemination of information to only relevant group of people. This could be a kind of federated environment where information can be created, accessed and shared. However, Infobuttons can play a major role to facilitate the standard way of communication with knowledge e-resources.
F.
Information Security and Privacy
Information privacy is a big issue in any collaborative environment where it is required to share information for some decision making. Healthcare practitioners need patient information for treatment.
Challenge(s):
How to assure that this information are shared to only required group of people before deciding what to share and what to not? b.
Anonymity is important to keep in situations when the data has to be used only for research purposes.
D ISCUSSION ON SIGNIFICANCE OF THE WORK
V.
C ONCLUSION
This research is important from both theory and practice perspective. Theoretically this work will result in a model where social media will properly be linked to healthcare systems. Practically it will be useful for patients to get better care in fast and cost-effective way. Generally, this work has worth to consider, we are living in the age where every internet user is affected from social media either positively or negatively. Literature shows that 36% [1] Americans want to see what other consumers say about medication and treatment.
Patients can be empowered to get cheap and speedy access to value-added information and physicians’ advices. Physicians can benefit from experience of other physicians for some chronic decease diagnosis. The outputs of collaborated efforts of practitioners can be inputted to CDSS for certain deceases.
This work can play significant role to achieve Millennium
Development Goal 6 (MDG 6) [17] i.e. “To combat HIV/AIDS, malaria, and other diseases”. Users of social mediated healthcare system are allowed to view/share up to date information taken from trusted sources on various diseases.
The global emphasis on interoperable EMR/EHR systems has increased in recent years. At the same time, use of social media among the internet users is also increased. Health 2.0 main focus is also the innovations in healthcare domain through the use of social media participation. The proposed idea in this paper focuses on meaningful integration of social media with healthcare information systems. The idea is envisioned to facilitate both physicians and patients to change their life styles.
The authors are unable to present a coherent view of the overall framework proposed however the critical requirements are identified augmented with challenging research question(s).
In future work, we will look into the answers of these questions and will put efforts to propose a comprehensive architecture to this problem. Also we will see how to align Infobuttons
Standards with our solution in meaningful way.
R EFERENCES
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