Harnessing the power of social media in optimizing health outcomes

The advent of internet and mobile telephony has made tremendous impact in people's lives. The global penetration of mobile phones as estimated by International Telecommunications Union in 2011 was 87% which has facilitated the explosion in information technology. This has even been facilitated further by the emergence of social media platforms. The traditional model of service delivery is under threat due to these advances in technology. The healthcare field which has undergone tremendous technological revolution in virtually all spheres of service provision is also embracing social media, albeit late compared to other sectors. More and more health care stakeholders be it patients, providers or facilities are taking to social media to spread or seek for services In this article, we offer insights on the role of online resources especially social media platforms in healthcare settings. We demonstrate the benefits accrued from being active on the social media from the perspectives of patients, healthcare providers and health facilities. We also highlight the pitfalls that should be borne in mind when transacting affairs using social media platforms. Through this discussion, we seek to inspire the healthcare industry in resource limited settings to embrace social media which has a potential of enhancing efficiency and effectiveness of service provision.


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][2][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, egames, 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][5][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

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 Page number not for citation purposes 3 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.

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][17][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][20][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 Page number not for citation purposes 4 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.