To profile social networkers and those who use social networks for medical purposes and investigate the role of three behavioural triggers related to control, trust and privacy.
We use data from Europe (Eurobarometer 74.3, 2010) containing information about reported behaviour and perceptions on social issues such as media, privacy and social networking.
Probit models showing associations between individual socio-economic variables and reported social networking, and social networking for health. Extra variables proxying for control, trust in health care providers and privacy of personal information are then added. Following this, two part models accounting for zero observations are utilised.
The age profile of social networkers using it for medical care differs from that of social networkers per se. Privacy perceptions appear to be a deterrent of social networking whilst trust in the health care providers is not a significant driver of social network use.
There is some evidence of a digital divide owing to age, while income is not significantly associated with social networking for health. Social networking does not perfectly substitute for conventional health care.
Background: Social network analysis provides a perspective and method for inquiring into the structures that comprise online groups and communities. Traces from interaction via social media provide the opportunity for understanding how a community is formed and maintained online. Objective: The paper aims to demonstrate how social network analysis provides a vocabulary and set of techniques for examining interaction patterns via social media. Using the case of the #hcsmca online discussion forum, this paper highlights what has been and can be gained by approaching online community from a social network perspective, as well as providing an inside look at the structure of the #hcsmca community. Methods: Social network analysis was used to examine structures in a 1-month sample of Twitter messages with the hashtag #hcsmca (3871 tweets, 486 unique posters), which is the tag associated with the social media–supported group Health Care Social Media Canada. Network connections were considered present if the individual was mentioned, replied to, or had a post retweeted. Results: Network analyses revealed patterns of interaction that characterized the community as comprising one component, with a set of core participants prominent in the network due to their connections with others. Analysis showed the social media health content providers were the most influential group based on in-degree centrality. However, there was no preferential attachment among people in the same professional group, indicating that the formation of connections among community members was not constrained by professional status. Conclusions: Network analysis and visualizations provide techniques and a vocabulary for understanding online interaction, as well as insights that can help in understanding what, and who, comprises and sustains a network, and whether community emerges from a network of online interactions.
(J Med Internet Res 2013;15(10):e248) doi:10.2196/jmir.2796
Venoplasty has been proposed, alongside the theory of chronic cerebrospinal venous insufficiency (CCSVI), as a treatment for multiple sclerosis (MS). Despite concerns about its efficacy and safety, thousands of patients have undergone the procedure. This paper analyses YouTube videos where patients have shared their treatment experiences.
Content analysis on the 100 most viewed videos from over 4000 identified in a search for ‘CCSVI’, and qualitative thematic analysis on popular ‘channels’ demonstrating patients’ experiences.
Videos adopt an overwhelmingly positive stance towards CCSVI; many were uploaded by patients and present pre- and/or post-treatment experiences. Patients demonstrate rather than merely describe their symptoms, performing tests on themselves before and after treatment to quantify improvement. Videos combine medical terminology and tests with personal experiences of living with MS.
Social media technologies provide patients with novel opportunities for advocating for particular treatments; generating alternative forms of ‘evidence’ built on a hybrid of personal experience and medical knowledge.
Healthcare practitioners need to engage with new digital forms of content, including online social media. Instead of disregarding sources not considered ‘evidence-based’, practitioners should enhance their understanding of what ‘experiential-evidence’ is deemed significant to patients, particularly in contested areas of healthcare.
irst, inadequate attention has been paid to disentangling patient- vs clinician-level effects in studies of interventions aimed at evaluating the influence of SDM on utilization. An updated Cochrane review of decision aids for patients facing treatment or screening decisions suggested that “there was a reduction in the choice of major elective surgery in the group receiving the decision aid compared to usual care.”1 The conclusion was based on a summary analysis of 14 studies published between 1995 and 2009 that were very diverse in terms of the clinical decision context, practice setting, and features of the interventions. Importantly, only 5 of 14 studies showed a reduction in the more extensive treatment option, and several of these positive studies could not disentangle patient- vs clinician-level effects of the intervention on utilization. Despite these limitations, the review has been cited in a number of recent commentaries and research articles supporting the potential role of SDM in reducing overtreatment.
Suzie Rose asked four physicians on Twitter the clinical question: “Patient progresses with new myeloma lesion during induction therapy for autologous stem cell transplant (ASCT). What do you do clinically?” Three of us replied nearly simultaneously: “We need more information and timing of imaging vs Tx.” One said: “Depends. Sometimes proceed to ASCT, but if florid progressive disease (PD), consider changing regimen first. The response to that from @Myeloma_Doc: “I also agree. But, in general, rarely good to do transplant with disease progression.”
That exchange prompted this question from patient Suzie Rose: “What venues best for complexity? I already know the easy stuff. Your suggestions for a #myeloma forum will be helpful. Thanks.” Myeloma_Doc noted: “This scenario type best reviewed in a formal consult with #myeloma expert.” To which @myelomacinderel responded: “Suggestion for venue where #myeloma case scenarios get feedback. Not a consult. Please help. . .” She also noted that she was “betwixt and between” being a new patient and being a physician expert. She wanted more than basic information as often found on the Internet (even if from a reputable source likely Cancer.Net or a myeloma center), and she wanted it personalized to her specific molecular disease. She may also not benefit completely from programs like ASCO’s patientACCESS, which provides free patient access to the ASCO JCO and JOP journals.
When the feasibility of scaling from one motivated patient to a subset of all myeloma patients was questioned, Suzie Rose noted: “Economics rules again. What happened to learning for free? The quest for knowledge.” And @Myeloma_Doc replied that the “Issue is not economics. Important to get full picture to individualize best advice” and “Full picture = patient input. We need the patient for patient-centered therapy.” Dr. Tomasson (@MTomasson) joined the conversation with “Interesting idea…I can imagine ways to make it work.”
The theorization of health issues is crucial both for understanding and as a guide for action.
The new mobile wireless computer technologies and social media applications using Web 2.0 platforms have recently received attention from those working in health promotion as a promising new way of achieving their goals of preventing ill-health and promoting healthy behaviours at the population level. There is very little critical examination in this literature of how the use of these digital technologies may affect the targeted groups, in terms of the implications for how individuals experience embodiment, selfhood and social relationships. This article addresses these issues, employing a range of social and cultural theories to do so. It is argued that m-health technologies produce a digital cyborg body. They are able to act not only as prostheses, but also as interpreters of the body. The subject produced through the use of m-health technologies is constructed as both an object of surveillance and persuasion, and as a responsible citizen who is willing and able to act on the health imperatives issuing forth from the technologies and to present their body/self as open to continual measurement and assessment. The implications of this new way of monitoring and regulating health are discussed.
m-health; digital technologies; the cyborg; surveillance; health promotion; the body
To investigate patients’ and health professionals’ (a) motives and use of social media for health-related reasons, and (b) barriers and expectations for health-related social media use.
We conducted a descriptive online survey among 139 patients and 153 health care professionals in obstetrics and gynecology. In this survey, we asked the respondents about their motives and use of social network sites (SNS: Facebook and Hyves), Twitter, LinkedIn, and YouTube.
Results showed that patients primarily used Twitter (59.9%), especially for increasing knowledge and exchanging advice and Facebook (52.3%), particularly for social support and exchanging advice. Professionals primarily used LinkedIn (70.7%) and Twitter (51.2%), for communication with their colleagues and marketing reasons. Patients’ main barriers for social media use were privacy concerns and unreliability of the information. Professionals’ main barriers were inefficiency and lack of skills. Both patients and professionals expected future social media use, provided that they can choose their time of social media usage.
The results indicate disconcordance in patients’ and professionals’ motives and use of social media in health care.
Smartphones as Multimodal Communication Devices to Facilitate Clinical Knowledge Processes: Randomized Controlled Trial
Background: Despite the widespread use and advancements of mobile technology that facilitate rich communication modes, there is little evidence demonstrating the value of smartphones for effective interclinician communication and knowledge processes. Objective: The objective of this study was to determine the effects of different synchronous smartphone-based modes of communication, such as (1) speech only, (2) speech and images, and (3) speech, images, and image annotation (guided noticing) on the recall and transfer of visually and verbally represented medical knowledge. Methods: The experiment was conducted from November 2011 to May 2012 at the University Hospital Basel (Switzerland) with 42 medical students in a master’s program. All participants analyzed a standardized case (a patient with a subcapital fracture of the fifth metacarpal bone) based on a radiological image, photographs of the hand, and textual descriptions, and were asked to consult a remote surgical specialist via a smartphone. Participants were randomly assigned to 3 experimental conditions/groups. In group 1, the specialist provided verbal explanations (speech only). In group 2, the specialist provided verbal explanations and displayed the radiological image and the photographs to the participants (speech and images). In group 3, the specialist provided verbal explanations, displayed the radiological image and the photographs, and annotated the radiological image by drawing structures/angle elements (speech, images, and image annotation). To assess knowledge recall, participants were asked to write brief summaries of the case (verbally represented knowledge) after the consultation and to re-analyze the diagnostic images (visually represented knowledge). To assess knowledge transfer, participants analyzed a similar case without specialist support. Results: Data analysis by ANOVA found that participants in groups 2 and 3 (images used) evaluated the support provided by the specialist as significantly more positive than group 1, the speech-only group (group 1: mean 4.08, SD 0.90; group 2: mean 4.73, SD 0.59; group 3: mean 4.93, SD 0.25; F2,39=6.76, P=.003; partial η2=0.26, 1–β=.90). However, significant positive effects on the recall and transfer of visually represented medical knowledge were only observed when the smartphone-based communication involved the combination of speech, images, and image annotation (group 3). There were no significant positive effects on the recall and transfer of visually represented knowledge between group 1 (speech only) and group 2 (speech and images). No significant differences were observed between the groups regarding verbally represented medical knowledge. Conclusions: The results show (1) the value of annotation functions for digital and mobile technology for interclinician communication and medical informatics, and (2) the use of guided noticing (the integration of speech, images, and image annotation) leads to significantly improved knowledge gains for visually represented knowledge. This is particularly valuable in situations involving complex visual subject matters, typical in clinical practice.
A portrait of the 45% of U.S. adults living with chronic health conditions
45% of U.S. adults report that they live with one or more chronic conditions, such as high blood pressure and diabetes, but also less common conditions like lupus and cancer. They are more likely than other adults to be older, to have faced a medical emergency in the past year, and, as other studies have shown, to contribute to the explosion of health care costs in the U.S.
A new national survey by the Pew Research Center, supported by the California HealthCare Foundation, explores how adults with chronic conditions gather, share, and create health information, both online and offline.
The Pew Research Center’s analysis indicates a “diagnosis difference” that is tied to several aspects of health care and technology use. For example, holding other variables constant (including age, income, education, ethnicity, and overall health status), the fact that someone has a chronic condition is independently associated with being offline.
Being a medical futurist means I work on bringing disruptive technologies to medicine & healthcare; assisting medical professionals and students in using these in an efficient and secure way; a...
Being a medical futurist means I work on bringing disruptive technologies to medicine & healthcare; assisting medical professionals and students in using these in an efficient and secure way; and educating e-patients about how to become equal partners with their caregivers.
Based on what we see in other industries, this is going to be an exploding series of changes and while redesigning healthcare takes a lot of time and efforts, the best we can do is to prepare all stakeholders for what is coming next. That was the reason behind creating The Guide to the Future of Medicine white paper which you can download for free.
Patient engagement was a major theme of the Partners Connected Health Symposium, and that theme came to a head Thursday with a talk from Epic President Carl Dvorak, who contends that for electronic health records like Epic, engagement with the patients is “the last mile,” the home stretch EHR vendors are currently embarking on.
Everything Epic does to innovate, Dvorak said, he assumes will soon become standard for EHR systems, just like car stereos were once a feature you had to purchase separately and now are just assumed to be part of a new car.
This paper addresses the issue of interactivity on health consumer websites powered by health organizations, by presenting the design of PARAFORUM, an interactive website in the field of spinal cord injury (SCI).
The design of PARAFORUM is based on different streams of research in online health communication, web-based communities, open innovation communities and formative evaluation with stakeholders.
PARAFORUM implements a model of diversified interactivity based on individuals with SCI and their families, health professionals, and researchers sharing their expertise in SCI. In addition to traditional health professional/researcher-to-consumer and peer-to-peer interactions, through PARAFORUM consumers, health professionals and researchers can co-design ideas for the enhancement of practice and research on SCI.
There is the need to reflect on the conceptualization and operationalization of interactivity on consumer health websites. Interactions between different users can make these websites important platforms for promoting self-management of chronic conditions, organizational innovation, and participatory research.
Interactivity on consumer health websites is a main resource for health communication. Health organizations are invited to build interactive websites, by considering, however, that the exploitation of interactivity require users’ collaboration, processes and standards for managing content, creating and translating knowledge, and conducting internet-based studies