Authors
- Krowchuk, Heidi V. PhD, RN, FAAN
- Lane, Susan H. MSN, RN
- Twaddell, Jennifer W.
Article Content
PRO
In my opinion, social media (SM), Internet and mobile-based tools for distributing and sharing information, should be used for communication between healthcare providers (HCPs) and patients, since SM has the potential to educate, engage, and empower patients as well as HCPs.
About 61% of adult Americans routinely access health information online, and a majority of them rely on either blogs, online news groups, or personal Web sites to obtain it (Fox & Jones, 2009). Therefore, it is in the best interest of both that HCPs use SM to enhance their educational efforts with patients. One essential function for HCPs in 2009 and beyond is helping their patients to filter incorrect or archaic information they may have read online from inaccurate and unreliable sources. This is critical when reports show that 60% of Internet users with chronic conditions allow information received from the Internet to influence their personal healthcare decisions, and between 45% and 57% share their healthcare experiences via SM like Facebook(Fox & Jones, 2009).
Healthcare models have been developed with innovative methods of connecting HCPs and patients through e-mail, instant messaging, and video chat. One of these is the Hello Health model in Brooklyn, NY, which has demonstrated success in using SM to communicate with patients (Hawn, 2009). In this program, HCPs have created a secure social network to engage their patients, and patients, after paying an enrollment fee, have access to their HCPs through the practice's private Web site, e-mail, and instant messaging; patients are assured that they will be seen within 24 hours should their health problem need an in-office consultation. Benefits of this model include communication speed and accessibility to HCP through SM tools, increased numbers of interactions with HCPs, and a reduction in overhead costs to the practice by cutting telephone usage, paper, postage, and administrative tasks/time. Insurance plans currently do not cover programs such as Hello Health; therefore, they are few in number (Hawn).
Healthcare access and quality, reducing health disparities, and improving cultural competence are concerns for the HCPs. It could be that these problems may be overcome through the use of SM and its concomitant improvement in patient/HCP communication. In addition, SM are not limited by geographic boundaries, so HCPs can connect with patients lacking transportation, or those who are located in rural areas with limited healthcare services. Also, patients with specific culture or language needs can connect to HCPs who share culture or language, thus enhancing their healthcare experience, creating optimal communication, and perhaps narrowing gaps in health disparities through increased patient empowerment.
The trend toward SM use in healthcare is inevitable, for as technology improves, access to SM will increase. Already, wireless connections have made it possible to access information and communicate just about anywhere, so individuals are more engaged (Fox & Jones, 2009). Nurses could use SM technology to improve the care they provide to patients and their families; for instance, recently it was reported that a patient undergoing surgery agreed to have a hospital employee use the SM tool Twitter to keep her family informed of her progress while the surgery was taking place. The employee was in the operating room and "tweeted" over 300 progress reports during the 3-hour surgery. Keeping the patient's family informed reduced the anxiety associated with the surgical event (Crumb, 2009)
Communication between HCPs and patients is critical to the success of the healthcare industry. While other disciplines have quickly adapted to technological changes, healthcare has thus far had a limited history of SM use, but I believe that HCPs must identify the benefits of using SM for patient communication and reallocate resources appropriately.
References
Crumb, M.J.(2009, September 2).Twitter opens door to Iowa operating room. The Associate Press. Retrieved September 13, 2009, from http://hosted.ap.org/dynamic/stories/U/US_TWEETING_SURGERY?SITE=OHCIN&SECTION=HO[Context Link]
Fox, S., & Jones, S. (2009). The social life of health information. Washington, DC: The Pew Internet and American Life Project. Retrieved August 3, 2009, from http://www.pewinternet.org/~/media//Files/Reports/2009/PIP_Health_2009.pdf[Context Link]
Hawn, C. (2009). Take two aspirin and tweet me in the morning: how Twitter, Facebook, and other social media are reshaping health care. Health Affairs, 28(2), 361-368. [Context Link]
CON
In my opinion, healthcare providers should not use SM tools to communicate with patients. Tools such as Facebook, Twitter, and MySpace are intended for peer interaction, not for professional relationships. Just imagine that a patient for whom you provide nursing care accessed your Facebook page and learned about your hobbies, lifestyle, political views, and even your preferences in music, and found some of this information to be disagreeable. Professional relationships built on mutual trust can be compromised when patients have access to personal information that undermines that trust. Likewise, providers who "friend" patients through social networking sites and learn personal information that could potentially affect the care they provide promote the distortion of the boundaries between provider and patient (McBride & Cohen, 2009).
Imagine further, that because of the nursing care you gave, the patient posts a question related to her health problem on your Facebook wall. Other "friends" included in your network can view the question as well as any response you may post. These "friends" could then make that information accessible to their "friends," thus dramatically increasing the audience that is privy to the communication. Legal issues need to be considered when personal information is shared, especially because nurses and other healthcare providers must comply with the HIPPA. Reports in the literature confirm that lawsuits against providers have occurred due to private patient information appearing in blogs, and on public Web sites and social networking sites (Hawn, 2009; McBride & Cohen, 2009).
The number of patients spending time on the Internet and accessing health-related information is increasing (Hawn, 2009). Some authors suggest that up to 75% of all patients use the Web to search for health information, with the fastest growing population between the ages of 70 and 75 years of age (Skiba, 2009); clearly the population of SM users, once confined to teenagers and young adults, is shifting toward older adults. While searching for trusted resources, patients are also looking online for you, the healthcare provider. How private and secure are your communications? Perhaps your hospital or clinic has a secure Web site for patients to use should they have questions, need further information about their health problems, or contact a healthcare provider, but you should find out who monitors the site for activity, whether the site is adequately protected against hackers who may get access to private information.
Another concern with using SM tools to communicate with patients has to do with the availability of the tools. Patients, particularly those of low income, may not be able to embrace SM technology due to the cost. While it is true that access has increased because of wireless technology, there are still many who don't have access (Skiba, 2009).
We also don't know if communication with patients using SM tools is actually effective in promoting health. Additionally, there is a need for research to examine the effect of SM on nursing practice. Likewise, standards for providing care using SM tools have not been established. What protocols will be needed to assure patient and provider safety if SM tools are used as part of routine healthcare? Can an e-mailed list of patient symptoms replace inspection, auscultation, and palpation done by a healthcare provider? Where is the listening ear, the caring touch, or the welcoming smile in an e-mail? I don't believe that SM interactions with our patients is in anyone's best interest.
References
McBride, D., & Cohen, E. (2009). Misuse of social networking may have ethical implications for nurses. ONS Connect, 24(7), 17. [Context Link]
Hawn, C. (2009). Take two aspirin and tweet me in the morning: How Twitter, Facebook, and other social media are reshaping health care. Health Affairs, 28(2), 361-368.
Skiba, D. J. (2009). Nursing practice 2.0: The wisdom of crowds. Nursing Education Perspectives, 30(3), 191-192. [Context Link]