People are drawn to web-based social networks because they trust them. This is as true for health as it is for car shopping music-sharing, and restaurant reviews.
Citizens' trust in institutions is eroding. In recent months, consumer confidence has plummeted due to the sub-prime mortgage crisis, the cost of energy and its impact on the price of food. In the health arena, people grow increasingly concerned about data breaches (such as WellPoint's recent data loss of 128,000 members' personal health information), the effectiveness of FDA in regulating food (such as salmonella risk in cereals) and drug supplies (e.g., Vioxx and Heparin), and ever-growing costs of health care that erode household purchasing power.
People Like Me
The erosion of peoples' faith in government and business leads us to find trust elsewhere. The first place we're going to look is with our peers.
Edelman, a global communications firm, has conducted the annual Trust Barometer survey since 2000. Two years ago, Edelman cited a new trend in its 2006 Trust Barometer: the steady decline of trust in traditional figures of authority, and the increase in the credibility of the "average person." The beginning of the trend was a huge spike in trust for a "person like yourself or your peer" from 22% in 2003 to 68% in 2006.
Edelman underscored this trend by noting the growth and increasing credibility of Internet communications that enabled access to peer opinions.
Fast Adoption of Health Social Networks Online
Social networks are nothing new. What is new is online networks transforming health care relationships between patients and stakeholder organizations with which people directly interact: physicians, hospitals, health plans and drug companies.
While searching is still the No.1 use of the Internet in health care, social media are growing in importance as consumers' preferred online channels for health knowledge. iCrossing found that 34% of Americans had used social media to access health- and wellness-related information in the last year (based on iCrossing's survey methodology, interviews took place online in early December 2007).
Within Internet social media, the most popular health site is Wikipedia, which is used by about one in five adults, followed by online forums, social networks (such as MySpace, Facebook and Second Life), video-sharing, blogs and live chat rooms.
The adoption of social media in health has occurred relatively quickly. Is this a good or bad development for peoples' state of personal health?
Balancing Health Network Benefits and Concerns
Consumers searching for health information online is inevitable. People are using search and social networks in health the way they use these tools for other aspects of daily living. Why should health be different?
It is, and it isn't. In the U.S., "consumer-directed" has become the accepted prefix for how health care is organized in this post-managed care era. As such, people are responsible for managing financial and clinical aspects of their personal health and the health of those for whom they care. Using online tools to solve problems is a natural activity for people, as discussed in a recent report from the Pew Internet & American Life Project. The Pew report found that, "more people turn to the internet (at home, work, libraries or other places) than any other source of information and support, including experts and family members."
Thus, the Internet is naturally a go-to source for health information and support. In fact, people use the Internet more for solid clinical and therapeutic knowledge than for support, which seemed to be the original reason many people went online. The top three reasons people go online for health-social networking are:
- To see what other consumers say about a medication or treatment: 36% of adults using social media for health;
- To research other consumers' knowledge and experiences: 31%; and
- To learn skills or get education that helps people manage a condition: 27%.
On balance, these three motivations would be seen as "good" uses of social networks.
On the downside, detractors of social networks in health argue that there is much dis-information and potential for malfeasance online. However, in the research I recently conducted for my report on social networks
in health for the California HealthCare Foundation, I found that those at the vanguard of social networks in health have found the opposite: Bad information is driven out by good, consistent with the theory of the wisdom of crowds.
The CDC gets social media in health
The one federal agency that Americans trust more than any other is CDC. Harris Interactive found consumers rated CDC higher than any other federal agency in a poll in 2007. CDC is an early adopter of social media in health -- apparently a fan of the wisdom of crowds for public health applications.
It is encouraging, then, that CDC has engaged social media in many projects over the past year. Most recently, CDC announced it will leverage social networks to encourage Americans to adopt personal health records. In his blog of Oct. 29, 2007, Jay Bernhardt, the Director of the National Center for Health Marketing at CDC, posted: "I believe more than ever that social media cannot just impact, but revolutionize, health."
CDC has worked with social media channels to promote HIV/AIDS prevention, teach people about flu prevention and work on smoking cessation innovations. It is working with MySpace, YouTube, SecondLife -- alongside American citizens whose tax payments fund CDC.
Bernhardt's view is that user-generated and peer-to-peer information exchanged through social media allow consumers to "constantly send and receive information that is more trusted, relevant and potentially influential."
Consumers Are Ahead of Stakeholders
CDC is a pioneering organization in the adoption of social media in health. Most other stakeholder organizations are way behind the people they serve.
Early adopters in social media and health include a handful of health plans, such as Blue Cross and Blue Shield of Minnesota's The Health Care Scoop, and the Zagat/Anthem Blue Cross and Blue Shield alliance. A few enlightened health care CEOs also blog: Paul Levy of Beth Israel Deaconess Medical Center in Boston writes "Running a Hospital"; Charlie Baker, the President and CEO of Harvard Pilgrim, pens the blog, "Let's Talk Healthcare"; and Nick Jacobs, CEO of Windber Medical Center, writes "Nick's Blog." These leaders represent the vanguard, and not the norm, of health industry actors.
Consumers expect their service companies -- their banks, their mortgage companies and their airlines -- to engage with them online. They look to the leaders of these organizations, and to their peers, to share insights and support. People wonder why health organizations can't respond to their needs in the same way.
CHCF publishes iHealthBeat.