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      Harnessing the power of social media in optimizing health outcomes

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          Abstract

          Commentary Since the advent of internet, there has been an explosion in the number of applications which have fundamentally revolutionized various sectors of life. The centerpiece of this communication advancement revolves around the position of social media [1–3]. Invariably, when social media is mentioned, many people associate it with Facebook, Twitter and You tube. However, social media comprises a myriad of online platforms ranging from micro blogs, blogs, social networking sites, wikis, video- and file- sharing, e-games, on line discussion forums, continuous professional education forums, research networking sites like research gate and information sharing sites like slide share, online training and seminars. The ease in accessibility and widespread use offers a cheap and easily available resource that can be harnessed in improving the health outcomes especially in developing countries. On the flipside, however, the variety of platforms elicits a variety of risks that negate these benefits. In medicine, particularly, the choice can be daunting since a wrong decision based on frivolous information may culminate in disastrous consequences. It is imperative for one to understand where most of their patients are deriving information to determine the reliability of the information. Benefits to patients and population The effects of social media and internet generally are beyond imaginable proportions. In this generation, a great number of people go online to seek answers to general health questions. Patients’ quest for information concerning a specific disease, treatments, alternative treatment, medical insurance, healthcare providers and medical facilities and their capacity can be fulfilled by just a touch of a button[4–6]. In a USA survey by Mediabistro, more than 50% of respondents said that they made changes in management of prevention of diseases based on online readings [7]. Moreover, more than 40% of people said they were likely to change their decisions after seeking answers online. The greatest users of social media are young people, 90% of whom are likely to trust medical information shared through these networks. Online support group networks created purposely for patients suffering from particular conditions facilitate sharing of information. This concept of patient group networking provides social support in today's highly fragmented society. They also help patients understand their conditions and offer opportunities for them to better cope with their disease. Therefore, there is subsequent improvement in management of conditions, limited occurrence of complications, reduced rates of hospitalization, reduced cost of illness and reduced loss of income. Through this model, patients can be educated by a trusted healthcare forum about the signs, symptoms and conditions that warrant attention of a healthcare provider[8]. This model is remarkably revolutionizing patient management in most of Western countries. Additionally, social media can be a channel of marshaling the public to be aware about conditions which are either in epidemic or endemic proportion[9]. Government efforts in combating or mitigating a public health problem can be communicated via social media forums to the public. Besides the real time relay of information, the expenses involved are minimized. Additionally, the disease surveillance feedback programs can relay information via this media from the public to a central body. A faster response to the problem can then be initiated in case of a problem. People can also be informed about various government initiatives in improving their health welfare. Benefits to healthcare professionals Though healthcare professionals are usually accused of their slow adoption of technology, the dynamics of patient care demand a paradigm shift from the traditional care model to the current model steered by social media[10]. The era of communicating disease information through booklets and pamphlets is almost being relegated to oblivion considering the ease, availability and minimal expenses involved when using social media forums. As a result of benefits reaped by being present on the platform, many health professionals are joining social media platforms [11]. Among the healthcare professionals, social media can promote the concept of crowd sourcing which though is controversial especially for highly sensitive areas like medicine, is the new fad in town[12]. Essentially, the concept revolves around harnessing the power of trusted healthcare workers on a given network to provide solutions to a given challenging clinical case the doctor is handling. While there is inherent fear of error in relying on some of the responses, the likelihood of zeroing in on appropriate management is increased. The issue of privacy may be a sensitive topic in the social media domain but in a survey by Mediabistro more than half of patients did not harbor any qualms against their care provider seeking answers of their medical condition through an online forum [7]. Interestingly, on some of the platforms, the practitioners post some interesting clinical vignettes from their practice for educative reasons[13]. This facilitates a wider body of knowledge on the disease. New products or drugs which have proven effective can also be explained appropriately to the HCPs through social platforms. Other online resources can be linked to such networks so that the members can acquire knowledge at their own time. Since there are a myriad of internet channels propagating various ways of managing conditions, healthcare professionals are obligated to generate educational content that will displace this misleading content[14, 15]. The techno savvy practitioners who run blogs can post comments that are beneficial not only among the patients but also towards fellow colleagues. Interesting articles that the author has come across can also be linked for other people to read. Microsoft's Dr. Bill Crounse proposition that blogging is the most effective way of promoting a health message adds impetus to creation of more blogs by professionals to fulfill this dictum. Google hangout platform provides a forum where the HCP can communicate or interact with his or her patients. This enables a better follow up on the patient conditions and institution of appropriate measures before complications set in. Benefits to health facilities Increasingly, health institutions are claiming presence on the social media not only as a marketing platform but as well as providing information concerning available services. The forums can also be used to lodge any complaints concerning the quality of services [16–18]. The Mayo clinic's marketing strategy through the 3 social media sites is a success story that has been emulated across the US. Currently, there are more than 800 hospitals which have active presence on social media. Through their social media forum, patients get to download podcasts, videos and engage in chats in a chat room. Unresolved issues Despite these immense benefits described, users and consumers of social media content should be wary of the inherent risks associated with unaccredited information. The web of information available through the outlets is so voluminous; it cannot lack obvious flaws which predispose users to bad and dangerous advice. In contention also is whether it is professional to use a forum that is laced with so much non medical activities for exchanging ideas among colleagues or with the patient. Additionally, there are various questions that emerge as regards patient's right to privacy and confidentiality when the case is shared among colleagues? Who vouches for the veracity of information relayed? Who will compensate the professional for engaging with the patient online? It is against such a background that institutions should come up with ways to compensate for this online consultation as well as limiting the risk of liability [19–21]. The greatest fear for any organization is controlling conversations on social media since some users may exploit such avenues to propagate negative publicity for the organization. It is therefore essential for health facilities to generate specific social media guidelines so that the staffs are on the same page and avoid the pitfalls of social media which can be used as channel for abusive content. Future of social media in the local healthcare setting So what is the future of social media? We note that not many hospitals in the local health care setting are on the social media. This may stem from strict regulations on promotional and advertising on the medical profession[22]. Even the health care providers’ platform KMPDU is mostly used to disseminate political and litigations news rather than medical information. The patient community platforms are rudimentarily developed so that not many patients derive benefits from such sites. Most of content obtained is foreign based and may not fit in the local setting. On the etiquette front, not many institutions have put in place guidelines on usage of social media. For a robust social media presence, one has to be accessible and visible on the search. A clear description of the location, office hours, services and charges ought to be made to ease the consultation process. There is urgent need for patients to be informed of the existence of various media platforms that can be used to communicate with the providers, health facilities or obtain validated information on their conditions. A study conducted in US revealed that 86% of people aged 55-64 years don't use social media while a mere 24% don't in those aged 18-24. It is therefore imperative that the elderly Kenyan counterparts need to be encouraged to embrace the digital age trends as regards health service provision[23]. Health facilities and providers should also strive to engage their patients on social media forums so that the process becomes a two way. All these should be premised against a robust social media health care policy. Conclusion In conclusion, social media not only accomplishes the mission of connecting doctors and their patients, but also enables patients to seek second opinion on decisions made. It also enhances social marketing of government and hospital services. While internet is no substitute for healthcare providers, it can enhance the depth of interaction between the clients and providers hence improving the health outcomes.

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          Most cited references21

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          Harnessing the cloud of patient experience: using social media to detect poor quality healthcare.

          Recent years have seen increasing interest in patient-centred care and calls to focus on improving the patient experience. At the same time, a growing number of patients are using the internet to describe their experiences of healthcare. We believe the increasing availability of patients' accounts of their care on blogs, social networks, Twitter and hospital review sites presents an intriguing opportunity to advance the patient-centred care agenda and provide novel quality of care data. We describe this concept as a 'cloud of patient experience'. In this commentary, we outline the ways in which the collection and aggregation of patients' descriptions of their experiences on the internet could be used to detect poor clinical care. Over time, such an approach could also identify excellence and allow it to be built on. We suggest using the techniques of natural language processing and sentiment analysis to transform unstructured descriptions of patient experience on the internet into usable measures of healthcare performance. We consider the various sources of information that could be used, the limitations of the approach and discuss whether these new techniques could detect poor performance before conventional measures of healthcare quality.
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            Social media use by health care professionals and trainees: a scoping review.

            To conduct a scoping review of the literature on social media use by health care professionals and trainees. The authors searched MEDLINE, CENTRAL, ERIC, PubMed, CINAHL Plus Full Text, Academic Search Complete, Alt Health Watch, Health Source, Communication and Mass Media Complete, Web of Knowledge, and ProQuest for studies published between 2000 and 2012. They included those reporting primary research on social media use by health care professionals or trainees. Two reviewers screened studies for eligibility; one reviewer extracted data and a second verified a 10% sample. They analyzed data descriptively to determine which social media tools were used, by whom, for what purposes, and how they were evaluated. The authors included 96 studies in their review. Discussion forums were the most commonly studied tools (43/96; 44.8%). Researchers more often studied social media in educational than practice settings. Of common specialties, administration, critical appraisal, and research appeared most often (11/96; 11.5%), followed by public health (9/96; 9.4%). The objective of most tools was to facilitate communication (59/96; 61.5%) or improve knowledge (41/96; 42.7%). Thirteen studies evaluated effectiveness (13.5%), and 41 (42.7%) used a cross-sectional design. These findings provide a map of the current literature on social media use in health care, identify gaps in that literature, and provide direction for future research. Social media use is widespread, particularly in education settings. The versatility of these tools suggests their suitability for use in a wide range of professional activities. Studies of their effectiveness could inform future practice.
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              Sourcing the crowd for health services improvement: The reflexive patient and "share-your-experience" websites.

              In countries where the notion of "reflexive patients" dominates the health policy landscape, patients are increasingly encouraged to publicize their personal experiences with health services provision by reviewing hospitals and professionals on the web. The number of websites where patients can review one or more aspects of their care (and read reviews posted by others) is growing. These sites are an example of the practice of crowdsourcing, where applications that facilitate user-generated content solicit feedback from a given public; site administrators then use this feedback for product development, quality improvement and policy change. The research presented here examines such developments in the context of ongoing discussions about reflexive consumerism and increased transparency in healthcare. It draws on data from a three-year study of share-your-experience sites in the U.S., U.K., and The Netherlands. Data is taken primarily from a discourse analysis of four of the six sites under study, including patient reviews of institutions and professionals (n=450). Supplementary data from interviews with stakeholders related to the Dutch sites (n=15) is also used. This is the first known study of multiple share-your-experience websites in different countries. It shows that monitoring as "reflexive" behavior is not automatic, but is encouraged by website creators who, hoping to use the posts for other purposes, act as mediators between patients and other healthcare stakeholders. It further argues that patients demonstrate more reflexivity than some stakeholders realize, although not necessarily in the way that Giddens proposed. It concludes with the argument that the focus on reflexivity in healthcare means that not only institutions must be more transparent about their performance; patients are expected to be more transparent about their choices, as well. Copyright © 2011 Elsevier Ltd. All rights reserved.
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                Author and article information

                Journal
                Pan Afr Med J
                Pan Afr Med J
                PAMJ
                The Pan African Medical Journal
                The African Field Epidemiology Network
                1937-8688
                14 August 2014
                2014
                : 18
                : 290
                Affiliations
                [1 ]University of Nairobi, School of Medicine, Kenya
                Author notes
                [& ]Corresponding author: Henry Nyongesa, University of Nairobi, School of Medicine, Kenya
                Article
                PAMJ-18-290
                10.11604/pamj.2014.18.290.4634
                4247867
                25469184
                55dd1d2c-1892-4033-a12d-66a1a53b6458
                © Henry Nyongesa et al.

                The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 19 May 2014
                : 13 August 2014
                Categories
                Commentary

                Medicine
                social media,health outcome,mobile phone
                Medicine
                social media, health outcome, mobile phone

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