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Walsh, L.;  Hyett, N.;  Juniper, N.;  Li, C.;  Hill, S. Social Media for Health Service Design and Quality. Encyclopedia. Available online: https://encyclopedia.pub/entry/38220 (accessed on 03 July 2024).
Walsh L,  Hyett N,  Juniper N,  Li C,  Hill S. Social Media for Health Service Design and Quality. Encyclopedia. Available at: https://encyclopedia.pub/entry/38220. Accessed July 03, 2024.
Walsh, Louisa, Nerida Hyett, Nicole Juniper, Chi Li, Sophie Hill. "Social Media for Health Service Design and Quality" Encyclopedia, https://encyclopedia.pub/entry/38220 (accessed July 03, 2024).
Walsh, L.,  Hyett, N.,  Juniper, N.,  Li, C., & Hill, S. (2022, December 07). Social Media for Health Service Design and Quality. In Encyclopedia. https://encyclopedia.pub/entry/38220
Walsh, Louisa, et al. "Social Media for Health Service Design and Quality." Encyclopedia. Web. 07 December, 2022.
Social Media for Health Service Design and Quality
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This entry is adapted from the peer-reviewed paper 10.3390/ijerph192214851

Health organisations and stakeholders use social media for a range of functions, including engaging stakeholders in the design and quality improvement (QI) of services. Social media may help overcome some of the limitations of traditional stakeholder engagement methods. Risks/limitations included low quality of engagement and harms to users. Limited access and familiarity with social media were frequently reported barriers. Making discussions safe and facilitating access were common enablers. 

social media quality improvement health services

1. Introduction

Social media has shaped the internet since Web 2.0 was defined in 2004 [1]. Social media are any online platforms that allows users to create or curate content, interact and form social networks [2]. Its use is extremely widespread, with over 4.2 billion people worldwide having at least one social media account [3]. People use social media sites for a variety of health-related purposes, including searching for health information [4][5][6][7], finding support for their condition [5][7][8] and as an aid for self-management [7][8]. Health organisations also use social media as way to increase consumer access to health information [6].
Social media can also be used to facilitate the engagement consumers and other stakeholders in activities to change, design, or improve health services [9]. Batalden and Davidoff (2007) [10] define quality improvement (QI) in health as “the combined and unceasing efforts of everyone—healthcare professionals, patients and their families, researchers, payers, planners and educators—to make the changes that will lead to better patient outcomes, better system performance and better professional development (pg 1).” Definitions of health service design also emphasise different organisational stakeholders working together, but with a focus on creativity to imagine and enable innovations in practice or process within organisations, networks or wider service ecosystems [11]. Designing and improving services not only involved internal processes, but also external drivers, such as stakeholders agitating for change through advocacy and activism [12] and the economic and social environment of the health service [13][14] Based on these definitions, it is clear that design and QI in health services is not just the role of service providers or health organisations, but of all stakeholders in health, and is influenced by both internal external factors.
Stakeholder engagement in health service design and QI which includes consumers has been shown to improve patient access and outcomes [15][16][17], and improve patient-centred care [18]. However, there are barriers associated with traditional face-to-face engagement methods, such as insufficient resourcing [16][18][19] and training [19], a lack of representation of people from socially disadvantaged groups [20][21][22], and concerns about the representativeness of small numbers of consumers engaged in activities [17]. Using social media for engagement has been proposed as one way that health services could address some of the limitations or barriers of traditional stakeholder engagement methods [21][23][24][25][26].

2. The Importance of Engaging New Audiences and Overcoming Underutilisation

Social media may assist in helping health services engage new audiences in the process of QI [27][28][29][30][31][32][33][34][35][36][37][38][39][40][41], but success was mixed with many studies reporting underutilisation by target audiences [28][30][31][32][33][35][39][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59], particularly by people viewed as ‘hard-to-reach’ [60]. Based on their experience as stakeholders involved in health design and QI, the advisory committee believed that the most practical ways to overcome this limitation were educating potential users on how to use social media [30][31][36][61][62][63][64][65] and using social media in addition to other, more traditional methods of engagement (e.g., face to face) rather than relying on social media alone [30][31][36][37][38][40][44][49][64][66][67].

3. Managing Negative, False or Malicious Messaging

The risk of negative, false or malicious messaging was highlighted as an important finding, even though this risk was only mentioned in thirteen studies [27][28][30][31][39][43][45][49][55][57][59][68][69]. The discrepancy between the relatively small number of included studies which viewed negative, false or malicious messaging as a risk, and the importance placed on this risk by the advisory committee members may reflect issues around delays between conducting and publishing academic research in the context of a rapidly changing digital environment. For example, issues such as the strategic use of misinformation and bots to influence policy debate have only emerged in some of the more recent studies [43][44][45][57]. Other recent social media issues, such as social media algorithms creating highly polarised filter bubbles [70], and selling of user data to third parties [71], were not investigated in the studies included. It is likely that these issues will emerge in future research, particular given the complex advocacy, social support, information- and misinformation-dissemination role that social media has played in the COVID-19 pandemic [72]. Future research should continue to explore emergent risks and barriers to social media use and how they can be managed or overcome.
The advisory committee felt that the strategies of monitoring [36][46][55][64][67][68][73][74], moderation [46][64][66][75] and group rules [64][66] reported within the theme of ‘making discussions safe’ were the most important and relevant ways to manage the risk of negative, false or malicious messaging for stakeholders engaged in health service design or QI activities. Given the perceived importance of these strategies in making social media spaces safer, researchers would have expected they would be more frequently reported as an enabler for using social media to engage stakeholders in design and QI. This potential under-reporting of moderation, monitoring and group rules may reflect the types of platforms and their access features used in the included studies. Monitoring and moderation are likely easier to undertake and report on in registration-required or closed social media environments, where monitoring and moderation of small online groups is likely done by group members, organisers or paid content moderators [76]. The potential under-reporting of monitoring and moderation may be because the majority of included studies occurred in public social media spaces, where monitoring and moderation may be done through often opaque artificial intelligence mechanisms or anonymous reporting of problematic content [77], and is therefore difficult to report on, or not identified as an enabler in research articles.
Whatever the reason for the potential under-reporting of monitoring, moderation and group rules, the fact that the advisory committee highlighted the importance of these strategies indicates that they may be a key area for future research, in order to better understand the impacts of monitoring and moderation practices on stakeholder engagement in health service and system design and QI.

4. Building Relationships

Social media can have positive impacts on trust and the quality of relationships between consumers and their providers or health organisations. The potential for social media use to make organisations more transparent [30][31][47][49][55][64], and help consumers better understand how organisations work [30][31], are possible ways to overcome the distrust that some consumers may feel towards health services [78]. Related to this could be the potential of social media to create more collaborative relationships, through both the levelling of hierarchies [35][65][67][79] and facilitating interactions between people and groups who rarely interact [32][35][37][39][41][56][61][64][80][81][82], creating new opportunities for innovation.
However, the findings of the review also demonstrate that this experience of improved relationships is not universal. Some of the included studies identify risks of negative experiences for users through social media messaging or online behaviour [28][30][31][39][49][57][59][69], or just an inability to reach key user groups for relationship building [28][30][31][32][33][35][39][43][44][45][47][48][50][51][54][55][57][59]. These risks and limitations would need to be managed if relationship building through social media were to be successful.

Anonymity

There was some discrepancy between consumers wanting some ability to maintain privacy and anonymity in social media spaces [41][67], and providers wanting to restrict the ability for users to be fully anonymous or use pseudonyms [74], although this was only reported in a small number of studies. This discrepancy may be reflective of the type of activities being conducted and the participants involved. For example, both of the studies which advocated for anonymity in social media spaces examined the experiences of consumers who shared experiences of care to try and influence change at the health service [67] or public health policy [41] levels. Moorley et al. (2014) found value in undisguised interactions between members of a health professional group using social media for networking and seeking professional advice [74]. Discrepant findings are expected given the range of audiences, populations and issues reviewed and the complexity of modes of social media use [9]. Future efforts by services could be informed by models and examples that are relevant to their needs and aims [9] and by planning social media use in health service design and QI activities in partnership with advisory groups of clinical and consumer stakeholders [83].

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Contributors MDPI registered users' name will be linked to their SciProfiles pages. To register with us, please refer to https://encyclopedia.pub/register :
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