Healthcare Quarterly Vol.16 No.1 2013 63

Neil Seeman and Karen Born Social Media in Healthcare: It’s So Five Years Ago?

62 Healthcare Quarterly Vol.16 No.1 2013

Social Media in Healthcare: It’s So Five Years Ago?Neil Seeman and Karen Born

Not so long ago (2007), sites such as Twitter were relatively free of “spambots” and robotic marketers promoting or demoting brands. Facebook was innocent and not in the business of collecting

more than two billion “likes” every day and selling the data. It’s a different world today. Five years ago, using social media to engage was innovative. Not so today. In fact, it is questionable that the return on investment of engagement using social media ever lived up to the hype. Despite much attention paid to the role of social media in the United States presidential campaigns of 2008 and 2012, the return on investment of social media in that context is dubious – that is, whether younger people voted in “record numbers” and this translated into a statistically meaningful upswing in voting for this demographic.

This is not to dismiss the power of social media in health-care, just to put it in the context of innovation. The rest of industry and the investor community, from Silicon Valley to New York to London, is talking about “Big Data” – harvesting and making sense of exabytes of information (five of which are being created every 10 minutes) that get produced daily on the Web. Yet healthcare is still (yawn) focusing on yesterday’s innovation: social media. Technically, the idea of splitting the

Web into social and non-social is absurd today. The entire Web is social. As you are reading this, you have the ability to “share” it on Facebook or LinkedIn, “tweet” about it or email it to your “friends” and contacts. Google, Amazon, Twitter – sites you use every day– are, in fact, social in functionality. In spite of how pervasive these tools are in our personal and work lives, hospitals and healthcare providers remain reticent to embrace social media to improve the main focus of the healthcare sector – patient communication and care.

“ Healthcare is still (yawn) focusing on yesterday’s innovation: social media.”

One must be clear: despite the promise of social media in healthcare, while extremely powerful for philanthropic campaigns and for gleaning information (from open source conversations on sites such as Twitter) about potential rapid improvement events (RIEs) of value to the community of care, it has shown no demonstrable benefit to clinical outcomes. That may change with new evidence. Social media has offered the

promise of “citizen science” (via, for example, Patientslikeme.com’s ALS Lithium Study, where patients organized their own clinical trial about the supposed benefits of lithium for amyotrophic lateral sclerosis).

A 2012 report “Ready to Interact: Social Media Use by U.S. Hospitals and Healthy Systems” from Computer Sciences Corp. (CSC), a United States technology consulting firm, focused on the use of social media in the United States for communica-tions and marketing and brand development, as well as the use of social media tools by hospitals. The survey drew on a small sample size (36) of US healthcare organizations that already used social media (this being a small sample set of self-selected leading organizations), so one needs to be careful about giving its findings too much weight: the main finding (not statistically significant) was that the most common purpose for the use of social media was for promoting health and wellness.

Indeed, in the Canadian context, some hospitals are using social media tools such as Facebook or YouTube for this purpose; but given Canada’s broader system and policy context of a publicly funded healthcare system, Canadian hospitals are being creative and using these social media tools primarily for purposes such as public education, staff engagement and quality improvement. Social media tools are cheap and, in a current cost-constrained context, offer an approach for hospitals to communicate and engage with various audiences.

“ Despite the fact that social media is not innovative today, the reach of social media tools to the public by healthcare organizations is still in its infancy in Canada.”

The Canadian context finds many other players engaged in social media. Healthcare increasingly spans far beyond acute care hospitals, and social media tools are being used by profes-sional groups (e.g., the Ontario Medical Association), educators (e.g., medical school and teaching hospitals), healthcare providers (e.g., Quinte Pediatrics) and other organizations (e.g., the Ontario Hospital Association) to connect, communicate and engage both within the healthcare context and beyond. There is a very small but vocal community of “activated e-patients” who are leveraging using social media to advocate for change – often simple change, such as being able to email your physician (a 20th-century tool used in every other service sector). Nevertheless, this community remains one of healthcare insiders, speaking primarily to each other, with little measurable impact.

Despite the fact that social media is not innovative today – that was the second generation of the Web; we are now well into the third – the reach of social media tools to the public by healthcare

organizations is still in its infancy in Canada. Still, there are lessons from the areas where social media has been better developed for hospitals as they try to do broader public engagement. The CSC report (at p. 5) was correct when noting, “Our finding of high levels of social media usage for the purposes of marketing, commu-nications and brand management are very consistent with other research, which has found that the vast majority of institutions use social media for unidirectional communication.” Within the small (early adopter) sample CSC discussed, 70% of the hospi-tals reported that they use social media to engage patients and consumers; yet really when one delves deeper, the reviewers find only one-way engagement. Again, one must put this in context: only a small subset of Facebook users adopts the most interactive features, such as video chat. Definitions are important here. Even self-broadcasting (i.e., sending out continuing medical education information via Twitter, for which the Mayo Clinic is a leader) is more social, or at least more engaging, than the pre-1997 modality of sticking static information on a website.

“ Social media has offered the promise of “citizen science.”

One-way engagement by hospitals and other organizations is still very much how the Canadian scene is characterized, but there is an interest in investigating further into the use of rich online data by hospitals for quality improvement and patient safety. This is the real promise of social media, to improve the bottom line in healthcare – patient outcomes. But let’s be clear: social media is like the telephone. It is yesterday’s invention. The main lesson the CSC report indirectly showed is that healthcare is a laggard. What else is new?

ReferenceCSC. October 2012. Ready to Interact: Social Media Use by U.S. Hospitals and Health Systems. Retrieved February 10, 2013. <http://assets1.csc.com/health_services/downloads/CSC_Survey_Social_Media_Use_by_U.S._Hospitals_and_Health_Systems.pdf>.

About the AuthorsNeil Seeman is founder and chief executive officer (CEO) of The RIWI Corporation, a global data capture company that works with high data-sensitivity clients around the world, is senior resident and CEO of the Health Strategy Innovation Cell at Massey College, and teaches knowledge transfer over the Internet at the University of Toronto’s Institute for Health Policy, Management and Evaluation. He is an author of four academic policy books and adjunct faculty at the Dalla Lana School of Public Health and at Ryerson University, in Toronto, Ontario.

Karen Born is a PhD candidate at the Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, and with the Li Ka Shing Knowledge Institute of St. Michaels, in Toronto.

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