Healthcare, Patients, and Social Media

A 2017 survey by the International Food Information Council Foundation found that 1 of every 3 respondents identified weight loss as the most desired benefit to get from foods or nutrients. This is a common topic of discussion and it is worth noting that those participating in the survey had high trust in advice from Registered Dietitians/Nutritionists. However men, in particular, also trust information from friends/family, wellness counselors, healthcare professionals on TV/social media, and food companies.

Healthcare professionals should expect that patients will use online sources for information regarding a specific medical condition (McMullen, 2006). While there are challenges with misinformation and ensuring that patients receive appropriate medical care and attention, social media can also help empower patients (Househ, et al., 2014; Conrad, et al., 2016). Furthermore, social sharing of mobile apps appear to be influencing patient behavior and social media use (Santoro, et al., 2015) and mobile apps for self-diagnosis and remote healthcare visits are increasingly used (Lupton and Jutel, 2015).  In 2016, Smailhodzic, et al., reported social media use by patients had

In 2016, Smailhodzic, et al., reported social media use by patients had both positive and negative effects, including the following:

• Improved self-management and control
• Enhanced psychological well-being and enhanced subjective well-being
• Diminished subjective well-being
• Addiction to social media
• Loss of privacy
• Being targeted for promotion

Social media use for health-related information is not limited to patients. In a 2012 Physicians Practice article, Westgate offered tips to ensure physicians address a patient’s use of internet resources during a healthcare visit suggesting that helping them identify sources of credible information will help reduce anxiety and the need to address misinformation. She suggests identifying the patient’s current practices, advising them of credible information, and providing information during an office visit.

A common topic such as weight management and the benefit of low-calorie sweeteners and diet foods and beverages is useful in considering how your practice may address credible information.

• Ask patients and their families what websites they use for diet and health information. While a practitioner may consider excess weight to be a health concern, some patients and family members may focus more on diet patterns. Patients trying to identify potential diet changes to make may search for topics such as “foods to avoid” or “foods that cause weight gain”. Such search terms may lead to very different information than searching for “long-term weight management”, “weight and metabolic syndrome”. Identifying the sources of information can help a practitioner identify patient motivation and potential barriers  that can be addressed.
• Advise patients to use credible sites. It may be helpful to outline productive and effective ways to search for information and suggest healthcare professional sites, especially those dedicated to specific illnesses. For example, the Academy of Nutrition and Dietetics, the American Academy of Family Physicians, the American Diabetes Association, and American Heart Association all provide credible information for patients interested in using low-calorie sweeteners for weight loss. The National Library of Medicine also provides advice on credible internet sites and specific health topics including sweeteners and sugar substitutes.
• Provide patients with handouts or regular updates on healthcare information. This is increasingly easy to do for practices that use electronic health information portals that patients have access to. Another option is to include a list of credible resources on your website and encourage your patients to establish the habit of using your office and resources as their first choice for care. It is important to consider sharing both factual information as well as lifestyle information, such as the advice and recipes found here, which may help provide patients and their families with practical tips to help facilitate behavior change.

While social media provides a number of opportunities, healthcare professionals should also consider the professional obligations associated with the use of these sites. The importance of adhering to existing ethical and legal standards when engaging in social media has already been included in policies by several healthcare organizations including the Academy of Nutrition and Dietetics (AND), American Medical Association (AMA), American Nurses Association (ANA), American Society of Health System Pharmacists (ASHP),and the National Council of State Boards of Nursing (NCSBN). Gagnon and Sabus (2015) expand on considerations for individual best practices including:

• Defined goals and objectives including the audience and purpose of social media presence as a professional.
• Protecting patient privacy and confidentiality in all forms of communications, including social media.
• Understanding and adhering to employer / organizational policies regarding social media.
• Take ownership and responsibility of your views and posts.
• Think carefully before creating separate personal and professional identities on social media platforms.
• Practice professionalism including in digital content.
• Control information sharing.
• Be agile and flexible in the changing digital landscape and explore your options for online communication with patients.
• Monitor your online identity.

References:

• Conrad P, Bandini J, Vasquez A. Illness and the Internet: From Private to Public Experience. Health (London). 2016 Jan;20(1):22-32.
• Househ M, Borycki E, Kushniruk A. Empowering patients through social media: the benefits and challenges. Health Informatics J. 2014 Mar;20(1):50-8.
• Gagnon K, Sabus C2. Professionalism in a digital age: opportunities and considerations for using social media in health care. Phys Ther. 2015 Mar;95(3):406-14.
• Lupton D, Jutel A. ‘It’s like having a physician in your pocket!’ A critical analysis of self-diagnosis smartphone apps. Soc Sci Med. 2015 May;133:128-35.
• McMullan M. Patients using the Internet to obtain health information: how this affects the patient-health professional relationship. Patient Educ Couns. 2006 Oct;63(1-2):24-8.
• Santoro, E., Castelnuovo, G., Zoppis, I., Mauri, G., & Sicurello, F. (2015). Social media and mobile applications in chronic disease prevention and management. Frontiers in Psychology, 6, 567.
• Smailhodzic E, Hooijsma W, Boonstra A, Langley DJ. Social media use in healthcare: A systematic review of effects on patients and on their relationship with healthcare professionals. BMC Health Serv Res. 2016 Aug 26;16:442.