Some reflections on social media and primary health care

As mentioned in the previous post, some of those at the recent Primary Health Care Research Conference in Brisbane have written reports arising from a workshop about how primary health care might harness the digital revolution.

In the articles below:

• Natasha Pavlin looks at some of the challenges for those in the health sector wanting to engage with social media (you can follow her on Twitter here).
• Pippa Burns weighs the pros and cons of engaging with social media and decides she doesn’t want to be left behind.
• Pam Harnden provides a comprehensive report on the workshop discussions.

At the bottom of the post are some tweets related to the session.

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Institutionalising social media: hard times for control freaks

Natasha Pavlin writes:

Do you ever wish that you could get other people in your organisation excited about using social media? Or do you worry that they will be excited, and you will have to be too, and it will be all too much?

Participants at the PHCRIS on Thursday 13th July enjoyed a small intense workshop session with Melissa Sweet exploring the ideas around “institutionalising social media”.

The group had a wide range of participants on both age and discipline (although all but one were female) and all worked in health, research or primary care in some form or other.

Everyone in the group was curious about the potential social media could have for them at work – both on an organisational level and in a day to day sense. Everyone also had some reservations.

Not only in our group but across the room there was consensus that one of the most important questions to consider is – what is your purpose in using social media?

Is it networking, information dissemination, looking for feedback, accessing new audiences, increasing interaction with members/users or something else?

Your purpose will inform many aspects of how you engage with social media. This may be something that can evolve once you get started but it needs to be clear at the beginning.

All the people in the group saw substantial barriers – again both personal and organisational.

One of the biggest fears was time. Time to learn how to do it, time to engage with it, will it just be another black hole like the email inbox? Will it be a waste of time – or perceived as such by your organisation?

The other barrier almost everyone raised, except for those already tweeting and blogging their hearts out, was “I don’t know how to do it! I’m scared of learning and don’t know where to start.”

The biggest organisational fear people saw in their workplaces was concern about effects on their “brand” through association with whatever is written about them online or through conversations that arise around their brand that they have no control of.

As Melissa Sweet (@croakeyblog) told us: the digital media age presages hard times for control freaks!

As a starting point for those beginning conversation within their organisations, Melissa directed us to the Victorian Department of Justice’ social media policy which is progressive, positive and thoughtful.

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Joining the conversation: primary health care research and social media

Pippa Burns writes:

Last week was pivotal for me in that I realised that I can no longer exist without a Twitter account.

It began on Monday, while watching a popular television show, when I realised that by not having a Twitter account not only was I being excluded from participating in the program but also that I had no idea about the jargon associated with the technology.

What on earth was a hash tag? And is trending good or bad?

Two days later I watched The Honourable Mark Butler, MP, at the annual Primary Health Care Conference in Brisbane repeatedly refer audience questions to his Twitter account.

While I’m sure I wasn’t the only person in the audience not yet Tweeting, it was obvious that people are already using Twitter to talk about wide ranging issues.

However, for me this poses a number of dilemmas, not least of which is the personal-professional divide. While I have an active Facebook account and a Blog, I’m not sure that I need or want colleagues knowing what I’ve been up to on the weekend or when I’ve had a bad day.

The need for each of us to create and manage our online brand is becoming increasingly more pertinent with the permanence of information posted on the Internet.

It’s currently almost a necessity to have online profiles on sites such as LinkedIn, Accademia, Facebook and Twitter, adding to the list of demands on our time.

Failing to embrace social media prevents us from staying abreast of current debates and developments and potentially reduces the reach and influence of the research we produce.

Social media also allows us to engage with our communities and elicit comments and contributions from consumers. Facebook in particular enables subject recruitment by posting adverts to the profiles of users that fit the basic demographics that we provide. Further, research findings can be distributed in a timely manner, with no geographic constraints and at minimum cost.

However, as with all new technologies there are drawbacks, not least of which is access to the Internet. We know that Internet is lowest amongst disadvantaged groups such as those with the lowest incomes, those with the least education and people living in rural and remote communities. By using social media, we are potentially widening the divide.

Use of social media also presumes that those with Internet access have adequate literacy, e-literacy and health literacy in order to adequately interpret the information being presented. Further, with the rise in citizen-journalism there is no way of ensuring the integrity of the information being provided and from preventing people from self-diagnosing or self-treating based on wrong or flawed information.

So while I recognise that it’s about time that I invest in a smart phone and join in the conversation, I’m currently hesitant to embrace this technology as the sole means of communicating with our audiences.

The technologies will continue to evolve and advance and it’s important that we as practitioners and researchers don’t get left behind.

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A comprehensive report on the workshop discussions

Pam Harnden writes:

I was particularly drawn to this workshop because as a former New Zealand independent midwife, I am an avid social media user (my husband points out far too avid at times!).

I have seen the slow growth of health care providers using social media networks to inform the public, share and support each other across a worldwide stage.

I have also found that I am connected and have access to a wider variety of people, across many countries. It has opened up my world, increased my knowledge and does not recognise the barriers of language and social class.

I am going to steal Melissa’s phrase of, ‘citizen journalism’ to describe my social media space after attending this workshop.

Melissa opened up the session with a general introduction to the world of Twitter and instead of being asked to turn off our mobile phones, we were actively encouraged to tweet from the session.

Tweeting involves sharing 140 characters sound bite from your day, it is described as mini blogging. ‘Hash tags’ can connect tweets. Tweeting from this session or the conference as a whole could be connected by adding the hash tag, #phcris. This enables Twitter users to single out the subject of #phcris and gather all the information people are putting out about the conference.

There are a number of questions that as groups we attempted to address in this workshop.

Is there a way organisations can approach social media in a positive way rather than a risk management way?

Many hospitals and health care providers block and ban the staff from using social media sites such as Facebook because they see the potential for time wasting for staff. There has also been a focus on the few privacy issues that have arisen within the spaces.

Maybe there is also a general reluctance to take the time out and investigate the benefits of information sharing with it all being placed in the ‘too hard basket’ of policy makers.

It is also difficult for those who hold positions of influence to harness the potential for information sharing within these spaces if they themselves don’t understand how they can be used.

Is there a way that we, as healthcare providers can be proactive rather than reactive in social media?

There has been a report written and released in June 2011 about how to use social media to improve healthcare quality. The Mayo Clinic is leading the way as an example. ABC Open is working to keep people informed. Social media is now democratising healthcare.

In the workshop we divided into six large groups and chose amongst ourselves what question or aspect we wanted to address using social media. As usual there were time constraints with the exercise and much of the time is used gathering the thoughts of the particular group.

Group One – Issues institutionalising social media

This group looked at the barriers, fears and benefits of using social media.

Some of the benefits highlighted by this group included using social media to recruit for research, engaging an audience in an online discussion group and gaining feedback from consumers about services provided.

The main barriers this group identified were the fear factor of using social media, brand effects of negative feedback in an open space, feeling overwhelmed and the potential for corruption by whoever is in charge.

Group Two – Young mothers, crying babies and how to settle babies

This group chose a subject and looked at how social media could be used to better connect and support this group within their communities. This is a particularly hot topic at the moment as it has been suggested that new mothers are attending A and E departments out of hours distressed and unable to settle their babies.

The group looked to providing social media support in the form of GPs, lactation consultants, midwives and other new mothers. This gives a clear purpose to the dissemination of reliable information from professional sources. It also has the potential to keep mothers in their home environments and out of hospital departments. However, the group did identify the problem of indemnity responsibility, maintaining control of people providing information and receiving information and they felt it raised more questions than answers.

Group Three – Support group for people with chronic diseases

This group explored the possibility of using social media to provide support to those suffering chronic diseases. They discussed that as reasonably educated people they were not knowledgeable enough about how it works and how to use it effectively.

Outcomes would be difficult to measure and how would you know what understanding your target audience were gaining? One concern which was raised was the potential for the ‘cafeteria group mentality’ to infect the space. Often within hospital settings staff have seen how chronic disease patients and their relatives often know about each other’s conditions and healthcare. They have a tendency to discuss it in the hospital canteen and over bedsides. Whilst this may be safe in the hospital environment, it may not be so safe in the worldwide openness of social media. This led to the conclusion that the professionals who use and moderate the space of social media need to have and increased awareness of their online presence, thorough knowledge of what mediums to use and how to use them effectively.

Group Four – Again looked at institutionalising social media

This group felt there were generic purposes to social media use, dissemination of knowledge and gaining feedback from consumers. They felt there were issues around permanence of information and technological limitations from within their organisations. They acknowledged that hospitals often deny access and that social media itself was evolving all the time. They felt that the landscape of social media might be drastically different in five years time. This group highlighted the potential impact of health organisations starting up an initiative and then failing and the impact that would have on resourcing.

Group Five – General anxieties

This group looked at and highlighted the general anxieties of language and literacy barriers where English was not the first language and poor literacy was an issue. They discussed how to take advantage of the language settings in social media.

Group Six – Engagement

This group mainly highlighted some of the issues that previous groups had already discussed. However their discussion raised concerns about how to not over engage in social media, missing the physical connection to people and not just targeting one group in the social media circle.

Wrapping up

What I gained from this session, and what I have personal experience of, is that social media is a vast resource of information and ability to connect with people.

Health care providers are in danger of being crippled by their own fear of the unknown and will be left behind in the wake. There are countless recent examples of how people have been left following disasters with social media as their only means of gaining information and connecting with the outside world.

We cannot as responsible health care providers afford to be left behind, we need to be more proactive and get in with the in crowd.

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Tweets about the session

These tweets from health consumer advocate Darlene Cox illustrate nicely how Twitter enables value-adding to presentations.

Meanwhile, these tweets from University of Queensland researcher Bronwyn Hemsley show how Twitter enables people to contribute even if they are not at the actual event.