Hashtags and Health Literacy: How Social Media Transforms Engagement

Source: HIMSS Patient Literacy and Health IT Work Group
by James Bell III, MSW Policy Analyst, Michigan Public Health Institute and Jon Mertz, Vice President, Corepoint Health

Clinicians have situated themselves in the perfect position to capture their patients’ attention. In 2012, the world renowned Mayo Clinic Health System provided care for just over one million people. As of February 2015, the Mayo Clinic had over one million followers on Twitter, greater than 550,000 likes on Facebook and more than 23,000 subscribed on YouTube. Physicians and their respective organizations are moving in droves to reach their patients through phone, computer, tweeting, texting and posting.

Now that the healthcare world’s social media presence has been established, there is potential to do more than advance a health system’s brand. There is an untapped power in social media: the power to make patients healthier by targeting health literacy.

There are many definitions of health literacy floating around, but the Institute of Medicine coined it perfectly, suggesting health literacy is the degree to which individuals can obtain, process, and understand basic health information and the services they need to make fitting decisions about health. In essence, when a patient does not understand the complications of his or her diagnosis and the associated prevention or treatment plans, an adverse event is likely to occur. 

The Health Literacy Challenge and How Social Media Can Help

Targeted social media messaging can be used to help break down barriers to health literacy, especially in the areas of patient-physician communication, medication adherence and informed consent.

 Patient-Physician Communication

There have been moments when we are sitting in the doctor’s office after wrapping up a long appointment and the doctor or nurse begins to tell us all of the things we should be doing to lead healthier lives. And as we step out of the door, that conversation all but dissipates, or we miss out on asking that one vital question.

The Joint Commission acknowledges communication breakdowns, between care providers and between providers and their patients is the crux of nearly 3,000 events reported to the Joint Commission and the high-ranking as an underlying medical malpractice cause. Effective communication is the foundation of patient safety and communication must be improved to clarify patient’s literacy levels and their personal expectations. 

Although social media is not the most appropriate platform for direct patient-physician communication, it can be used to remind patients to ask questions. Social media can also direct patients to the appropriate secure communication channels, such as their patient portals. When patients use social media to ask health questions, a smart social media strategy would be to put a “no wrong door” policy in effect. The social media manager can answer general health questions or direct patients to secure channels for addressing more personal health information.

Medication Adherence

Dr. C. Everett Koop, MD, past US Surgeon General probably said it best: “Drugs don’t work in patients who don’t take them.” Despite the fact that patients who adhere to their medication experience better health outcomes, the World Health Organization estimates average medical compliance rates in developed counties is about 50%.

There is so much more behind medical non-adherence than being responsible for understanding what it means to take two tablets by mouth twice daily. Medical non-adherence, whether intentional or unintentional, is similar to the physician-patient relationship. It is important to recognize the patient’s perspective; particularly their understanding about their medicines and their need for specific treatments.  

Providers need to be in a position to offer clear, relevant information on their condition and discuss the instructions they present. Social media offers an opportunity to gently remind patients to adhere to their medication schedules long after their last office visit is fresh in their minds.

Informed Consent        

Healthcare settings often rely very heavily on various forms and printed instructions to assist patients in making better health decisions. Unfortunately and frequently, informed consent documentation does not adequately consider an individual’s literacy or, more specifically, their health literacy. Patients may feel a degree of shame when they have trouble comprehending legal consent forms.

Effective communication is imperative for patients feeling comfortable with their health information. Social media must be able to leverage this to transform patients with lower health literacy. Using platforms like twitter and Facebook, health information can be shared in manageable, digestible chunks that may be less intimidating to patients with lower health literacy.

Social Media Connects Communities and Individuals to their Health

Just as health literacy can be defined in multiple ways, so can social media. Stated simply, social media is a conversation and a library. Social implies an exchange, and media implies data. Together, they can form a foundation to enable greater health literacy.

Social media is not the sole answer to solving the health literacy challenge. Social media creates an opportunity to reinforce messages, build community, and educate individuals. Through each of these elements, sharing is necessary component as is using what is shared as “a” source, not “the” source, of information.

Build Community

Healthcare takes a community. No matter if it is fitness, chronic conditions, or serious illness, care requires community. Social media extends our community to new relationships, whether through Facebook, secure patient communities, or open online forums. We can connect beyond our immediate four walls yet share a common health bond with others in remote and urban areas.

Community forms closer to our home, too. Physicians play a key role in this by offering portals and blogs. In the ongoing conversations, we learn more. Patients play a key role, too, especially when we can gather around common goals or challenges. Community keeps the conversations going as we leave a physician’s office.

Within a community, being responsible is vital. Be aware of your own privacy and what you share. Consider the information as an opportunity to broaden your perspective and form questions to ask your physician. Communities are imperfect, just as people are. But we can learn from each other and enhance our insights in becoming a more informed and engaged patient.

Reinforce Messages

Busyness has intensified. Physicians are as busy as patients are. In a fast-paced day, we can forget exact instructions. A physician cannot post reminders on each patient’s Facebook page (yet), but a dual responsibility can help. As an example, a patient can set timers on their mobile phone, and a physician can setup automated email reminders to specific patients. This is all part of the social technologies that exist today. Although this may not apply to all patients, this opportunity is growing for a larger part of the population as our digital footprint grows.

Technology is an enabler, and we need to use simple applications to keep us on a healthy track.

Educate Individuals

Education ties it all together. Through our interactions, we learn. More than this, there are many blogs and health communities available today. More are launching, as they should.

Every physician has a community, a constituency. More than this, each physician as a point of view. Beyond the 15-minute or less visit, physicians can highlight the reasons why taking medication as prescribed is essential. They can discuss the importance of vaccinations. They can raise consumer awareness about healthy habits. Physicians are called to serve their community through their insights delivered in a blog post, video, or other mediums.

For an individual, carving out time each week or month to read an article or post on health-related topics will make us smarter in our care. Many hospitals and clinics have YouTube channels or deliver information through Google Hangouts. Tap into the power of the information within your reach.

Social media and health literacy are a great match. One helps the other and the result is greater health literacy. The missing element is greater engagement. Social media can create the momentum that health literacy desperately needs. We just need to take the steps forward.

As a patient or physician, begin today by doing the following:

  • For patients, find a social community that fits your needs and jump in. Read, interact, ask, and become more aware and informed.
  • For physicians, create a social voice by writing a blog or posting a video. Two paragraphs or 30 seconds can deliver a message for others to consider and explore.
  • For all, spend the time with the people closest to you. Community begins at home and extends to your workplace and neighborhoods. Have a healthy conversation and challenge each other to learn more and ask better questions at your next health visit.

What are other ways social media can enhance health literacy? Join the community conversation on the HIMSS LinkedIn Group!

Additional Resources

Examples of physician blogs: