Webeditorial 3


Shanida Nataraja (AXON Communications)

The rise of the online social networks

Facebook, Twitter, Bebo, MySpace, LinkedIn, Friendster, YouTube. It is hard not to have heard of at least one of the numerous social networking sites that have sprung up in recent years. Since launching in 2004, Facebook has grown at an astronomical rate; it is now estimated that 250–350 million people in 170 countries across the globe have signed up to Facebook. LinkedIn, the professional networking site, now has an estimated 40 million users, and claim that a new user joins the network every 1 second. MySpace has 125 million users, and 7 million people Twitter more than 18 million pearls of wisdom every day. All of these online social networking sites allow users to create a profile for themselves, become friends with other users and share information with their network of friends.

For some, these social networking sites are a way of life, the only effective way of keeping in touch with increasingly global networks of friends. They provide forums in which to communicate, exchange ideas and share media, and streamline the processes of social interaction. For others, social networking sites are of questionable value, a poor substitute for real-life social networks that only act to isolate people further from their real-life connections. The vaguely narcissistic practice of some social networkers of broadcasting every last minute detail of their lives for all to see combined with stories of unwanted online reunions with old school friends is enough to dissuade many people from venturing near these sites.

However, for all of us working in medical education, no matter what our personal preferences, social networking sites are becoming too popular a trend to ignore. Do they represent another potential way of reaching out to patients and healthcare professionals? Can they be used to create opinion leader advocacy and encourage support of important medical education initiatives? And what does the future hold? Is this a trend that will last the test of time, and if so, how will the technology evolve to better meet the needs of the user? This article aims to answer all these and other questions.

The promise of social networking as a new medium for healthcare communications

Although the commercial potential of social networking sites is still in question, as many of the existing social networking sites, such as Facebook, struggle to make a profit, an increasing number of medical communication agencies are expanding their services to offer both consultancy and digital tools in the social networking arena. It is no longer sufficient for a pharmaceutical company or patient organisation to merely have a website. These bodies now must also have a presence on Facebook and Twitter to truly stand out, and doing so, they exploit yet another way of disseminating communications to their target audiences. Imagine you are a patient with Type 2 diabetes who is eagerly awaiting information about a new drug being developed as a treatment for your disease. By becoming a fan of the relevant pharmaceutical companies Facebook page, you can have the latest news broadcast to your own Facebook home page, and keep up-to-date with progress. Alternatively, you might subscribe to the Twitter page of that pharmaceutical company. In an age of information overload, social networking sites allow companies and organisations to deliver targeted communications to people who have expressed an interest in those communications.

A growing number of companies and organisations are also creating their own social networking platforms to ensure they fully exploit the opportunity offered by the new technology. Recently, for example, the Prostate Cancer InfoLink and Prostate Cancer International have collaborated to produce The "New" Prostate Cancer InfoLink Social Network (http://prostatecancerinfolink.ning.com). This social network is open to anyone with an interest in prostate cancer, from patients and their carers through to healthcare professionals, activists and advocates. Not only does this forum allow members to share information, but it also allows them to seek, receive and offer support. Similarly, another recent medical education initiative targeted teenagers looking for emergency contraception advice on the Internet. Launched in collaboration with Bebo and NHS Direct, this scheme offered instantaneous online advice to these teenagers. Whereas most teenagers are reluctant to seek advice in person or over the telephone, the online programme that allowed teenagers to chat online with an expert proved to be an effective way of delivering advice in an environment in which the teenager felt more at ease. Programmes such as these promise to more effectively target those individuals that are not normally reached with conventional medical education.

Interestingly, as social networking becomes more commonplace, the technology has also been applied to the healthcare setting in the form of ‘care networks’. Google Health is a relatively new social networking site that allows you to store and manage all of your health information in one central place and share your health records with individuals in your care network. This network can include family members, friends and doctors. All your medical records, laboratory test results and prescriptions can be uploaded to your health profile, so you, and your designated care network can access it, at any time. Through Google Health you can also link in to different services, such as the Cleveland Clinic MyConsult, which allows users to chat online with a physician, and ePillbox, which creates customised medication schedules based on the users prescriptions and personal preferences. If initiatives such as Google Health take off, they promise to revolutionise the way in which we manage our health. The ‘care network’ captures the way in which modern healthcare is delivered; a multidisciplinary team that includes healthcare professionals, patients and their carers. These online communities can, therefore, only act to facilitate patient care.

Social networking sites as a way of establishing and cultivating opinion leader advocacy

One of the key objectives for any company or organisation is to create advocacy for their products, services or mission. In a world in which interactions between pharmaceutical companies and key opinion leaders are heavily regulated, social networking sites also represent a way of keeping in touch with key influencers and advocates at a global scale without expensive and often impractical face-to-face meetings. Increasingly, pharmaceutical companies and patient organisations are turning to social networking sites to engage with their advocates. Boehringer-Ingelheim, for example, not only have a profile page for their company on YouTube, but they have also sponsored a Stroke Prevention YouTube channel (http://www.youtube.com/user/strokeprevention) that provides audio-visual information about stroke treatment and new clinical data on stroke prevention in patients with atrial fibrillation. As with other social networking sites, users of YouTube can become a fan or subscribe to these channels and thus be informed when new content is uploaded. A number of different proprietary social networking platforms have also been created that offer key opinion leaders virtual forums in which to exchange information and forge closer professional ties. Plug-ins that allow users to plan their time at upcoming conferences, search for members of the network with similar research interests, and pose discussion topics, all act to facilitate networking within these professional communities.

Although running symposia at key congresses across the globe used to be an initiative favoured by pharmaceutical companies, codex restrictions and competition for the best timeslots mean that the return on investment is not always as great as could be hoped for. With social networking technology, however, entire symposia can now be broadcast virtually, with an online instant messenger function that allow participants to pose questions to the speaker and participate in online discussion. The use of this technology is already widespread in the academic setting, in online training courses, and it is only a matter of time before these virtual meetings become much more commonplace in medical education as well. All the processes involved in delivering an event such as a symposium can be streamlined by using this technology. Discussions with speakers can be done online. Materials posted and reviewed online. Programme books and speaker slides can be made available for download. Interactive online polling can even be used to capture audience demographics and opinions before, during and after the symposium. In an age in which the definition and achievement of metrics of success are becoming increasingly important, social networking technology promises to allow information sharing, not only in terms of the network users sharing their expertise, but also in terms of generating important information for the site sponsors about opinion, unmet educational needs and prescribing patterns.

The future of social networking So what does the future hold for social networking?

In a recent article in Scientific American Mind, David DiSalvo predicts that social networking will need to evolve so that it better captures the way in which humans communicate. Current networking sites allow connected users to exchange messages or share media. Each user has a static profile, and is some cases a two-dimensional avatar, that represents them in the network. The networking sites of the future will allow users to interact with each other as holographic avatars that convey information about body posture, facial expressions, even tone of voice. More of the subtlety of human communications will, therefore, be relayed by this interface, thereby enriching the online experience. In a world of information overload, social networking sites also have the potential to filter out redundant information and highlight information of interest to the user. Many of the social networking sites already allow the sharing of media, including photos, videos and songs. In the future, our social networking sites will allow us to download a movie based on which films were recommended by people in our network or ask our doctor online for the antihypertensive favoured by our social network. As the number of social networking sites has become more prolific, there has also been a push towards the integration of these technologies, although some experts warn of the data privacy implications of doing so. Logging into three or more different sites to keep up-to-date with your friends and colleagues is needlessly complicated, and many networking sites now offer the ability to stream in feeds from your other networking sites. Whereas today, Google is the main gateway into the Internet, in the future, many of us will use our social networking sites as our home pages, and these one-stop sites will allow us to interact with our friends, visit websites they recommend to us, buy products they have bought, and search the Internet using filters that capture our personal preferences and interests, and those of our friends.

In summary, social networking sites already play an important role in our modern day society, and as a consequence may influence the way in which we deliver healthcare communications in general, and medical education specifically. In the same way as the number of health-related websites has grown considerably as it has become increasingly clear that more and more patients are searching for health information on the Internet, as the use of social networking sites increases, and people turn to their social and care networks for advice on their health, we have the opportunity to deliver important health information to a primed audience. Whether we Twitter about the importance of early diagnosis in prostate cancer, or start up a discussion on a Facebook page to understand the patient’s perspective on the impact of the side effects of chemotherapy, or release news of the regulatory approval of a new treatment for overactive bladder syndrome, we cannot afford to miss the opportunity to disseminate health information to the growing online community of social networkers.

In an exciting development, EMWA now has a profile page on both LinkedIn and Facebook. To keep up-to-date with latest EMWA news, and form network connections with other EMWA members, please join our LinkedIn group (www.linkedin.com) or become a fan of our Facebook page (www.facebook.com). We have also created a Twitter page (www.twitter.com/OfficialEMWA), so you can keep in touch with EMWA news through Twitter as well.