Social Media as a Tool in Medicine

1829 This article documents the emergence of social media, and specifically social network sites (SNS) and their impact on health information–seeking and health-related behaviors. We review surveys of user behavior on SNS to document how health information is being transformed into a social health experience rather than an individual or clinical endeavor. We then turn to the research evidence for how SNS may influence health behaviors. Although there is a substantial literature that provides support for the role of social variables in the genesis and management of health and disease, there is little scientific grounding for how to leverage these variables to improve health in either online or offline milieus. We conclude with recommendations for practice to optimize the use of social media and its contribution to improved health outcomes, and pose a series of questions that may guide the development of a research agenda in this area. The technological innovations of blogs, podcasts, interactive media, and SNS have enabled many people to create, post, and share their own messages and content by using a variety of digital social communication tools and platforms. People and organizations can now quickly create and deliver content through more interactive Web sites and online communities where, for example, people with medical conditions can seek, give, and receive advice from other patients and healthcare providers. New communication technologies and the emergence of what has been dubbed Web 2.0 are providing the opportunity for health professionals and patients alike to engage with 1 another, their peers, friends, and families in ways unimaginable just a few years ago. The speed and scale of adoption of social media is changing the way we think about and communicate with people formerly known as audiences and the way doctors and patients interact, bringing about a new social health experience. Yet, these social media and interactive elements have been poorly integrated into many health-related Web sites, for example, those dedicated to tobacco control. In its simplest forms, these media can be thought of as digital extensions of the interpersonal channels of connection and the narrowing of broadcast-type communication. They are increasing access to, connection with, and discussions of health information. The information is no longer static, but alive and moving—weaving through networks of individuals and communities whether onor offline. Thinking about these new media as just new communication channels misses the essence of what the new revolution is all about: using media in new ways. In this article, we review how people are using the Internet, social media, and specifically SNS in health and medicine to create a new social health experience. Health Information and the Internet As of August 2012, data from the Pew Internet & American Life Project found that ≈85% of all US adults use the Internet. These usage figures are equal for men and women (83% and 82%, respectively); show greater use by whites (84%) than by blacks and Hispanics (77% and 75% each); are age-related with 97% of people aged 18 to 29 years online versus 77% of people aged 50 to 64 years, and 53% of people over the age of 64; are associated with household income level (71% in households with annual income <$30 000/year versus 93% and higher once household income exceeds $50 000/year); and also vary by educational level from 58% among people with less than a high school education to 95% among people with college degrees and higher. Among teenagers, the comparable figures exceed 90% for sexes, all age groups, household income levels, and race/ethnicity, with the exception of Hispanics, where Internet use is reported to be 88%. Several surveys have documented the use of the Internet for health information seeking among adults. Tu reported that, in 2010, 58% of all American adults had searched for health and medical information online in the past year. Among those adults who report being online, the figure for that same year rises to 85%. Another nationally representative survey of 8745 US adults conducted during the third quarter of 2011 found that the average US adult seeks online health information about 3 times per month. The most popular health Web sites visited as of December 2012 were reported by eBizMBA to be (with unique monthly visitors in parentheses) Yahoo! Health (21.5 million), National Institutes of Health (20 million), WebMD (19.5 million), MedicineNet (10.5 million), and MayoClinic (7 million). Although it is not known how many of these visitors to health Web sites are unique individuals or are the same people accessing 2 or more sites in a single search, what is clear is that many millions of people are regularly turning to Web sites for health and medical information. With the rise of mobile phone and tablet ownership there is also increasing use of these devices for health information search; nearly 1 in 3 cell phone users have used their phone to search for health information. Health information search is becoming an anywhere, anytime activity. How people use the information they find through these searches has been the focus of several investigations. In a nationally representative survey of 17 000 US adults, Tu found that 56% of the people who had searched for health information on the Internet reported that the information affected their overall approach to maintaining their own health, and 60% said that the information affected their Digital Social Networks and Health