Transparency during the consumerization of healthcare

I’m at the Cleveland Clinic Patient Experience Summit, where, over the next few days, we’ll be considering the transformation of healthcare through empathy and innovation. We’re just a few hours in and have already heard from some great speakers, been brought to tears more than once by moving video storytelling, and discussed barriers to innovation from digital disparities, to cost of entry, to regulation and privacy issues, to patient expectations and clinical realities.

Dr. William Morris, Cleveland Clinic; Dr. Wayne Guerra, iTriage; Dr. Imad Najm, Cleveland Clinic; Adrei Pop, Human API

Dr. William Morris, Cleveland Clinic; Dr. Wayne Guerra, iTriage; Dr. Imad Najm, Cleveland Clinic; Adrei Pop, Human API

The overarching theme thus far – from Mobile App creators, to physicians, and a Google executive – is the need for transparency.

When mHealth is adopted in this country, it will be because consumers demand it. But, to get consumers engaged using telehealth and health-related apps, we (developers, communicators, physicians, etc.) have to set accurate expectations from the start. We have to educate users about what to expect from the app, and be completely transparent about its limitations, and – most importantly – be clear that technology should augment the consumer experience of healthcare, not replace physicians.

The onus is on mHealth brands – and their communication professionals – to help guide patient expectations. If mHealth is to be a consumer product, communicators need to help users to understand what apps can and can’t do to improve or facilitate health care and health information seeking. According to William Morris, the Associate Chief Medical Information Officer at Cleveland Clinic and award-winning innovator, customers need us to tell them that these “technologies aren’t meant to replace physicians, but to augment [medical care].”

Consumers will be disappointed unless they have realistic expectations. Simply adding a page on your website with consumer instructions will go a long way toward ensuring that your paying customers get the experience they think they’re paying for. More happy customers means more positive reviews, and ultimately, more amplification of your value proposition. That’s what we’re all after – right?

Where do you think the consumerization of health care will lead? Who do you want tomorrow’s patient to be and how can you help today’s patient to become that informed consumer?

Social Media in Pediatrics: A Risk-Laden Opportunity

Social media presents pediatricians with exciting new ways to engage with parents, expand the scope of their practices, and recruit new patients (Redsicker, 2012).  However, with progress comes the need for new guidelines that give examples of ethical use and identify risks.  While many businesses have embraced social media as a public relations tool, the majority of physicians are late adopters (Redsicker, 2012), possibly due to a combination of technological unfamiliarity and the fear of unintentionally breaching patient confidentiality.  Coupled with a general uncertainty about being reimbursed for their time spent online and concern about being inundated with emails, this fear of breaking the law is enough to keep many pediatricians away from social media.  Redsicker argues that the benefits of social media outweigh the potential risks when healthcare providers have social media guidelines that explain what should be avoided in social media communications, as well as provide examples of what can be done in order to maintain their relationships with patients in the social media age.

Social Media Research

Social media is an emerging phenomenon that academics are just beginning to explore; however, research has been published over the last two to three years that addresses social media use and there is some – limited – research on social media use among physicians.  Von Muhlen and Ohno-Machado (2012) conducted a literature review of 50 peer-reviewed social media adoption studies to determine current adoption trends among clinicians.  Researchers queried the Pubmed database using the keywords Facebook, social media, and Twitter, and extended the review to include relevant articles found on reference lists in their original search.  Von Muhlen and Ohno-Machado found 15 surveys related to social media adoption – mainly Facebook usage – conducted at a conference (N = 1) and online (N = 14).  Among those surveyed, students showed the highest usage rates at 64-96%, while professionals reported lower usage at 12.8-46.7%.  In addition to Facebook, students reported using Wikipedia and the Student Doctor Network as reference tools.  Concerns regarding the possible misuse of social media involved breaching patient confidentiality and publicizing unprofessional conduct, such as embarrassing photographs posted on Facebook that might negatively impact brand reputation and physician credibility.  Respondents indicated a need for social media training and guidelines for use.

One study of the patient-physician relationship on Facebook (von Muhlen and Ohno-Machado, 2012) suggests the adoption of the following guidelines: (a) do not accept patients as friends; (b) do not add information learned online about a patient to medical records; (c) do not disclose personal information online; and (d) know the limits of your privacy settings.  Other studies suggest setting up two different Facebook accounts: one for personal use and the other for strictly professional communications.  Setting up two accounts can be problematic as care needs to be taken to ensure that updates are posted under the correct identity, and friends could accidentally post personal information on the professional page.  Von Muhlen and Ohno-Machado recommend using the American Medical Association’s 2010 guidelines for professionalism in social media and site the need for further research in how physicians integrate social media into their practices.

Implications

While the American Medical Association’s guidelines are helpful, they do not speak to the unique position in which pediatricians find themselves as they care for their young patients who, depending on age, may or may not be online, and parents who are not only online, but are increasingly likely to consult Dr. Google, WebMD, or Wikipedia (Anderson, 2012) before calling the pediatrician’s office.  The American Academy of Pediatrics (2010) published social media guidelines for its local chapters, but they are not specific to primary care pediatrics.  Many hospital systems, such as the Cleveland Clinic Foundation (2012), have social media policies that highlight what not to do online, but give little to no guidance to help physicians engage their patients, grow their practices, and take advantage of the wealth of opportunities to raise awareness of health and safety issues that social media provides.  Pediatric groups need to work closely with their public relations professionals to establish social media best practices for their specialty that maintain their reputations as respectable resources of pediatric information, maximizing the opportunities, identifying potential legal pitfalls, and exploring the ethical quandaries associated with social media use.

To view my presentation documenting ways to encourage social media adoption by pediatricians, please click the following link: Diffusion of Innovations: Applications for Communications Professionals

References

American Academy of Pediatrics. (2010). Social media resource kit for AAP chapters. Retrieved from http://www.inaap.org/uploads/social.pdf

American Medical Association. (2010). New AMA policy helps guide physicians’ use of social media. Retrieved from http://www.ama-assn.org/ama/pub/news/news/social-media-policy.page

Anderson, K. (2012). Social media: A new way to care and communicate. Australian Nursing Journal, 20(3), 22-25.

Cleveland Clinic Foundation. (2012). Social media policy. Retrieved from http://my.clevelandclinic.org/about-cleveland-clinic/about-this-website/social-media-policy.aspx

Redsicker, P. (2012). AMA’s social media policy: Minimizing healthcare’s engagement risk. Retrieved from http://www.wordviewediting.com/amas-social-media-policy-minimizing-healthcares-engagement-risk/

von Muhlen, M., Ohno-Machado, L. (2012). Reviewing social media use by clinicians. Journal of the American Medical Informatics Association, 19, 777-781.