Abbielee Gardner
April 25, 2011
Health Communication – Dr. Bergstrom
Social Media in Health Care
Movies and television have always tended to reflect changes in our society. The writers
of ABCs Grey’s Anatomy took this concept to an extreme as they had Twitter guest star at
Seattle Grace Hospital. During this episode the Chief of surgery looked out into a sea of interns
and caught them all on their Blackberries, Droids and iPhones while he was operating. The
Chief scolds them for texting in the OR, but one of the interns explained that they aren’t texting;
they are following Dr. Bailey’s surgery on Twitter. Bailey’s interns are tweeting her surgery, so
even those who aren’t in the OR with her know what’s happening. After his surgery the chief
immediately tracks down Dr. Bailey and tells her to stop the tweeting explaining that he is
worried that broadcasting surgeries over the Internet would cause a lot of legal problems.
Despite his orders, Bailey continues to tweet and in the course of a surgery that has
complications she learns through Twitter that another local hospital has the equipment they need
to save their patient’s life. Even though this is a dramatization of the real medical arena, the
writers were not too far off the mark. Social media is beginning to and will continue to play a
prominent role in the health care industry.
Family physician, Dr. Ted Eytan is calling this transformation Health 2.0. His definition
of Health 2.0 is that it is participatory health care that is enabled by information, software and
community that we collect or create. We the patients can be effective partners in our own
healthcare, and we the people can participate in reshaping the health system itself (Hawn, 364).
Social media such as Twitter, Facebook, blogs, wikis and other social networks are all about
instant communication and more enriching communication. Hospitals and academic medical
centers are already using social media throughout the country, more than 300 YouTube channels
and over 500 Twitter accounts are active and are already making a difference. The Department
of Health and Human Services in 2009 established an entire center for social media to take
advantage of newer technology. The center proved its usefulness when in 2010 there was a
salmonella contamination of peanut butter and was able to spread the word quickly through
social networking sites.
The Internet contains enormous amounts of health information, and about three-quarters
of Internet users look online for health information. Using the Internet, patients can quickly
communicate with their physicians, receive prescriptions or have tests ordered all without an
office visit or phone call. Websites are popping up all over the place that are allowing patients to
take control of their medical decisions and most importantly their health. A national survey
concluded that most patients reported that taking information from the Internet to physicians was
beneficial, with 83 percent feeling more in control and 78 percent stating they felt more
confident during the physician visit (Lo, 20). Dr. Daniel Sands, director of medical informatics
at Cisco systems has been an avid role in developing patient centered websites such as,
patientsite.org. Patientsite.org allows patients to do a lot more than just send and read e-mails.
They can make appointments online, refill prescriptions and see personal test results. Dr. Sands
said, “These types of tools are really ultimately empowering for patients, because we’re giving
them what they need to care for themselves.” Social networking will also help doctors and
researchers spread their ideas and theories more widely and more effectively.
An important part of health care is having social support and social media is transforming
how patients interact with each other. It is helpful for patients to hear from people like
themselves who have a similar medical condition and social networking allows patients to
narrow information to what is relevant. Social networks can help clarify the meaning of test
results, offer emotional support, suggest coping strategies and how to deal with relatives. Rather
than rely on professionals to help patients understand and cope with complex technical
information, social media can help patients learn from people like themselves (Lo, 19).
Similar to other industries, the health care industry can use social media as an excellent
marketing tool. From advertisements on websites and maintaining social media pages,
healthcare marketing provides doctors with more ways to communicate with and follow up with
their patients. Social media can allow doctors to manage their online presence and reputation
because patients tend to search online for information about doctors and hospitals. In 2009,
Henry Ford Hospital in Detroit used Twitter to provide real-time updates of a surgery and
pointed viewers to YouTube footage of the procedure. Bill Ferris, manager of web services said,
“We think it exposes more people to the surgery technique. We got to interact with potential and
current patients.” Ferris also added, “Twitter lends itself well to covering an event that changes
incrementally, so surgery is a good fit for this technology.”
Social media and Internet technologies are also an excellent way to improve the doctorpatient relationship. Instead of spending doctor visits obtaining basic information like family
history, doctors can build information about patients from e-mails and can spend more time
addressing current concerns. If some patients do research before their appointments, doctors can
spend less time providing basic information and more time discussing the details of patients’
health. Technology can enable patients and doctors to communicate more often and more
openly, which can improve the quality of care received. Patients may also be willing to disclose
information through communication technology that they would otherwise be uncomfortable to
share face to face. A study conducted by Debra Roter found that in contrast to in person visits,
where doctors do most of the talking, patients do most of the “talking” on Internet
communication. They also reported that patients seem to feel more comfortable disclosing
emotions and praising and thanking their doctors online rather than in person because Internet
communication tends to be less intimidating and less time constrained. The study also found that
physicians’ responses to patients were usually more informative, reassuring and displayed
empathy (Roter). Social media and e-mail is a much needed time saver. E-mail allows doctors
to think though patient questions and to research them before replying. These communication
technologies give doctors the ability to communicate with patients and colleagues in long distant
or remote locations which reduces travel time and demands on office space and staff. These
technologies can also help eliminate the tedious game of phone tag.
The American Medical Association (AMA) has acknowledged the changes in patientdoctor relationships and has put out guidelines for doctors who are uncertain on how to proceed.
AMA has emphasized that e-mail and social media sites should be used to enhance existing
relationships and not replace person to person contact. Some guidelines include that a physician
should add a standard block of text to the end of e-mail messages to patients, which contains the
physician’s full name, contact information, reminders about security and the importance of
alternative forms of communication for emergencies. AMA also suggests that in order to protect
themselves doctors should retain either paper or electronic copies of patient interactions for their
records and always inform patients about privacy issues.
Although heath care may be one of America’s top industries it’s been among the slowest
to embrace advances in communication and information mainly due to the immense risks that
come with using social media. A study was conducted at Rouen University Hospital in France
that surveyed 405 postgraduate trainee doctors about their Facebook activities. Almost 73
percent said they had a Facebook profile and 24 percent logged on to the site several times a day,
but almost 49 percent logged on once a day or several times a week. Almost half believed that
the doctor-patient relationship would be changed if patients discovered their doctor had a
Facebook account. The survey concluded with 85 percent saying they would automatically
refuse a friend request from a patient. The reasons given for accepting a patient as a friend
included feeling an affinity with them and fear of embarrassing or losing that patient if they
declined (BMJ).
Some doctors are already feeling the disadvantages of communication technology.
Westerly Hospital in Rhode Island fired Dr. Alexandra Thran recently for posting patient data to
her personal profile on Facebook. Just like many other professionals with stressful jobs, Dr.
Thran had decided to vent on her personal profile after a long day at work. The problem is that in
the health industry patient privacy is of the most importance. Although the hospital admitted that
Thran had not revealed the patient’s name, they decided that she had provided enough details of
the patient’s injuries to allow others to guess who it was. This shows that social media policies
surrounding the doctor-patient relationship are not widespread or well defined yet. Since
guarding the privacy of patients’ health information is a key element in the health care system,
concerns about using social media have been raised. By definition, social networks are in
existence to facilitate communication among many parties simultaneously. Also, social
networks depend largely upon user-generated content. So as more members join social
networks, communication channels grow exponentially and the possibility of spreading incorrect
or problematic information, or information that should remain confidential also grows.
Health care providers using social media must remain mindful of professional boundaries
and their patients’ privacy rights. The Health Insurance Portability and Accountability Act of
1996 (HIPAA) addresses the use and disclosure of patients’ protected health information. The
act protects all individual health information held or transmitted by a health care organization, in
any form or media, whether electronic, paper or oral. The US Department of Health & Human
Services’ Office of Civil Rights (OCR) is responsible for enforcing HIPAA. Last year, OCR
investigated a case in New York City. An emergency medical technician who responded to a
call on Staten Island took a picture of a murder victim at a crime scene with his cell phone and
posted it on his Facebook page. The emergency medical technician was fired by his hospital and
is facing official misconduct charges in state criminal court (Hader, 271). The limits of
technology may restrict what patients and caregivers are able to convey to each other. Some
concerns have been raised that medical decisions will be made on the basis of incomplete or
misleading information. Michael Chamberlain, a behavioral scientist cautions that high-tech
methods cannot make up for poor communication: ‘No amount of technology is going to
compensate for an ill-conceived or ill-designed message. The buck stops there…with the
communicator.”
Social media allows for a more transparent, peer-to-peer communication between patients
and doctors and provides patients’ access to communities and groups that share similar interests
and medical conditions. Internet technologies such as social networking are an exploding market
and will continue to transform how we interact with the health care industry. Currently, groups
such as Microsoft and Google are developing Internet-based health platforms that allow patients
to combine health information from several sources, such as different clinics, laboratories or
hospitals, as well as additional information they enter themselves including family history, all
into a single comprehensive record. When it comes to what the future holds, regarding the health
care industry and technology, the possibilities are endless. Social media is a powerful tool for
communication and after all communication is at the heart of all good medicine.
Bibliography
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