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Using social media to engage consumers in health service design and quality improvement

Over the next two days (18-19 March) Croakey will be covering the Shifting Gears summit — the first Australian and New Zealand conference on consumer leadership and experience in health care.

Hosted by the Consumers Health Forum of Australia (CHF), the summit has an action packed all-online agenda, previewed in this recent Croakey post from Jennifer Doggett.

Friday’s agenda includes a presentation from PhD candidate Louisa Walsh, whose research centres around how hospitals use of social media to engage consumers in improving their services, and how this could be done safely, more often and better.

In the post below, and along with her supervisors Drs Nerida Hyett and Sophie Hill, Walsh discusses some of her findings so far, and issues an invitation to health services that might wish to participate in the next part of the project.

To join the Shifting Gears Summit, register here. You can follow the two days of events via #ShiftingGearsSummit on Twitter and via this Twitter list of participants.


Louisa Walsh, Nerida Hyett and Sophie Hill write:

Louisa Walsh

Social media has defined and shaped the internet for more than 15 years. Social media sites are among the most used websites in the world, and nearly 80% of Australians have at least one social media account.

In health services, using social media has been identified as a potential way to create more equal relationships between health professionals and consumers, increase participation in service design activities, and improve health service data collection.

Despite these potential benefits, it is likely that social media is underutilised as a communication tool in health.

Importantly, the two-way communication potential of social media, which is essential for these relationship building and participation benefits, is likely not being fulfilled. Our research aims to help hospitals, health professionals and consumers better understand how social media can be used as a tool to involve consumers in designing and improving health services. The project has three phases:

1) a review of the international literature;

2) an interview study with Australian health consumers and public hospital health professionals; and

3) a consultation on an evidence-based guide for health professionals and consumers wanting to use social media as part of their suite of consumer engagement activities.

The first two studies have been completed, and the first paper from the review of the international literature has just been published. The final study is about to commence.

How is social media used as a consumer engagement tool?

Through our research we have categorised the different ways social media can be used to engage people in service design and Quality Improvement (QI) activities: descriptions, examples and suitable platforms for each method can be found in the review.

Broadly speaking, social media can be used as either an information gathering tool, or as a space for collaboration where consumers and health professionals can work together on service design and QI projects.

A hospital asking their Facebook followers to comment on the new design of their outpatient area, or a consumer sending a direct message to a hospital’s Twitter account with feedback about recent hospital stay, are two different examples of gathering information through social media that can be used for design or improvement projects.

Virtual spaces can also be used for online co-design and collaboration, for example the online project management platform Slack could be used as a space for a hospital QI project working group which includes health professionals and consumers.

A call for consumer voices
QI survey

Benefits and risks of social media as a consumer engagement tool

There are benefits and risks of using social media for consumer engagement.

Social media can help overcome barriers associated with face-to-face engagement, such as time, costs and physically attending the hospital. Social media can also increase the number of people reached through engagement activities, and may improve the diversity of people engaged.

For consumers, using social media to initiate engagement with hospitals, or to more easily collectivise and advocate for change, is of particular benefit.

Finally, open communication on social media can increase organisational transparency, which can improve consumer trust and service reputation.

However, social media use is not without risk. Consumers and providers in our research were concerned about being harmed by other users through bullying, harassment, trolling, and privacy or professional behaviour breaches.

Organisational leaders were concerned about losing control over communications, particularly feedback mechanisms, which might lead to reputational harm.

Our research also identified that engaging consumers through social media might lead to poorer information, because in-depth discussion may be more difficult to achieve compared to face-to-face discussions.

It is important to note that the data informing these risks and benefits were collected before the onset of the COVID-19 pandemic. Recent important developments in social media, such as the rise in disinformation and corresponding strategies to combat it, and the Facebook news ban which temporarily shuttered the sites of many health-related organisations, might change perceptions of risks and harms.

How can hospitals implement social media as a consumer engagement tool?

Our research explored the barriers and enablers for social media for consumer engagement, and we are in the process of co-producing a guide for using social media as part of health service design and QI activities.

Firstly, organisations need to be set up for using social media. Hospitals play a large role in helping consumers and providers use social media for consumer engagement.

Good governance in the form of clear policies, processes and plans is vital, as is adequate training and resourcing. Social media interactions also need to be made safe through good monitoring and moderation practices, ground rules, and clear and accessible policies around privacy and data use.

Once an organisation is ‘social media ready’, social media-based consumer engagement plans need to be developed within each design or improvement project.

Project planners (which should include consumers) need to consider which method of social media use fits with the needs of the project and the target engagement group. Additional training and support may also be needed.

These additional considerations sit alongside all the usual planning that takes place when engaging with consumers in service design and QI activities.

Finally, we have found that sharing learning around social media-based consumer engagement gives other people and organisations confidence to try these methods.

If you are already doing social media-based consumer engagement, please find ways to share your experiences so others can learn from your knowledge and expertise – including via social media!

What’s next?

The next stage of the project is a consultation on the guide we are developing. If you are interested in being contacted when the consultation starts, or want to receive any of the publications from my project direct to your inbox, please get in touch!

*Louisa Walsh is a PhD candidate and Research Officer at the Centre for Health Communication and Participation, La Trobe University. On Twitter, @laqwalsh; Dr Nerida Hyett is a lecturer in Occupational Therapy at La Trobe Rural Health School, La Trobe University; Dr Sophie Hill is Director of of the Centre for Health Communication and Participation, La Trobe University

The authors would like to thank the advisory committee members who have contributed to this project – Jayne Howley, Nicole Juniper, Chi Li, Belinda MacLeod-Smith and Sophie Rodier.

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