The Unintended Consequences of Social Media in Healthcare: New Problems and New Solutions.

OBJECTIVES Social media is increasingly being used in conjunction with health information technology (health IT). The objective of this paper is to identify some of the undesirable outcomes that arise from this integration and to suggest solutions to these problems. METHODOLOGY After a discussion with experts to elicit the topics that should be included in the survey, we performed a narrative review based on recent literature and interviewed multidisciplinary experts from different areas. In each case, we identified and analyzed the unintended effects of social media in health IT. RESULTS Each analyzed topic provided a different set of unintended consequences. Most relevant consequences include lack of privacy with ethical and legal issues, patient confusion in disease management, poor information accuracy in crowdsourcing, unclear responsibilities, misleading and biased information in the prevention and detection of epidemics, and demotivation in gamified health solutions with social components. CONCLUSIONS Using social media in healthcare offers several benefits, but it is not exempt of potential problems, and not all of these problems have clear solutions. We recommend careful design of digital systems in order to minimize patient's feelings of demotivation and frustration and we recommend following specific guidelines that should be created by all stakeholders in the healthcare ecosystem.

[1]  Frada Burstein,et al.  Barriers of Using Social Media to Support Health-related Decisions: A Sociomaterial Perspective , 2014, DSS.

[2]  Miguel Angel Mayer,et al.  How medical doctors and students should use Social Media: a review of the main guidelines for proposing practical recommendations. , 2012, Studies in health technology and informatics.

[3]  M Househ,et al.  Ethical Issues of Social Media Usage in Healthcare , 2015, Yearbook of Medical Informatics.

[4]  I. Rahwan,et al.  Verification in Referral-Based Crowdsourcing , 2012, PloS one.

[5]  Matti Vuorinen,et al.  Assessment of Utility in Web Mining for the Domain of Public Health , 2010, Louhi@NAACL-HLT.

[6]  Jonathan White,et al.  ‘Have you seen what is on Facebook?’ The use of social networking software by healthcare professions students , 2013, BMJ Open.

[7]  K Denecke,et al.  How to Exploit Twitter for Public Health Monitoring? , 2013, Methods of Information in Medicine.

[8]  Andrea G. Parker,et al.  Spaceship Launch: Designing a Collaborative Exergame for Families , 2015, CSCW.

[9]  Sudakshina Lahiri,et al.  Targeting Parents for Childhood Weight Management: Development of a Theory-Driven and User-Centered Healthy Eating App , 2015, JMIR mHealth and uHealth.

[10]  Yeoreum Lee,et al.  Understanding the Roles and Influences of Mediators from Multiple Social Channels for Health Behavior Change , 2015, CSCW.

[11]  Jina Huh,et al.  Health Vlogs as Social Support for Chronic Illness Management , 2014, ACM Trans. Comput. Hum. Interact..

[12]  Jaime Jiménez-Pernett,et al.  Use of social media by Spanish hospitals: perceptions, difficulties, and success factors. , 2013, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[13]  Lena Maier-Hein,et al.  Can Masses of Non-Experts Train Highly Accurate Image Classifiers? - A Crowdsourcing Approach to Instrument Segmentation in Laparoscopic Images , 2014, MICCAI.

[14]  Enrique Castro-Sánchez,et al.  What makes people talk about antibiotics on social media? A retrospective analysis of Twitter use , 2014, The Journal of antimicrobial chemotherapy.

[15]  K. Dawson,et al.  The Intersection of Online Social Networking with Medical Professionalism , 2008, Journal of General Internal Medicine.

[16]  P. Schenarts,et al.  An assessment of unprofessional behavior among surgical residents on Facebook: a warning of the dangers of social media. , 2014, Journal of surgical education.

[17]  B. Zebrack,et al.  Psychosocial care of adolescent and young adult patients with cancer and survivors. , 2012, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[18]  Karin L. Becker Cyberhugs: Creating a Voice for Chronic Pain Sufferers Through Technology , 2013, Cyberpsychology Behav. Soc. Netw..

[19]  K. Riekert,et al.  User Preferences and Design Recommendations for an mHealth App to Promote Cystic Fibrosis Self-Management , 2014, JMIR mHealth and uHealth.

[20]  S. Sohn,et al.  Privacy, professionalism and Facebook: a dilemma for young doctors , 2010, Medical education.

[21]  N. Coulson,et al.  Online support group use and psychological health for individuals living with HIV/AIDS. , 2013, Patient education and counseling.

[22]  K. Denecke,et al.  Social Media and Internet-Based Data in Global Systems for Public Health Surveillance: A Systematic Review , 2014, The Milbank quarterly.

[23]  Kathleen Gray,et al.  Therapeutic Affordances of Social Media: Emergent Themes From a Global Online Survey of People With Chronic Pain , 2014, Journal of medical Internet research.

[24]  Beth Chaney,et al.  Web 2.0 Chronic Disease Self-Management for Older Adults: A Systematic Review , 2013, Journal of medical Internet research.

[25]  Elizabeth J Lyons,et al.  Behavior Change Techniques Implemented in Electronic Lifestyle Activity Monitors: A Systematic Content Analysis , 2014, Journal of medical Internet research.

[26]  J. Ancker,et al.  “You Get Reminded You’re a Sick Person”: Personal Data Tracking and Patients With Multiple Chronic Conditions , 2015, Journal of medical Internet research.

[27]  R. Kullar,et al.  Review of Twitter for infectious diseases clinicians: useful or a waste of time? , 2015, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[28]  J. Stockman Online Posting of Unprofessional Content by Medical Students , 2012 .

[29]  Sam Nordfeldt,et al.  Patient and Parent Views on a Web 2.0 Diabetes Portal—the Management Tool, the Generator, and the Gatekeeper: Qualitative Study , 2010, Journal of medical Internet research.

[30]  Kenneth W. Goodman,et al.  The IMIA Code of Ethics for Health Information Professionals , 2015 .

[31]  L. Fernández-Luque,et al.  Social Media in Health — What are the Safety Concerns for Health Consumers? , 2012, Health information management : journal of the Health Information Management Association of Australia.

[32]  Kerstin Denecke Ethical Aspects of Using Medical Social Media in Healthcare Applications , 2014, eHealth.

[33]  Mark Dredze,et al.  You Are What You Tweet: Analyzing Twitter for Public Health , 2011, ICWSM.

[34]  Leo Anthony Celi,et al.  Crowdsourcing Knowledge Discovery and Innovations in Medicine , 2014, Journal of medical Internet research.

[35]  P. Aslani,et al.  The use of social media in pharmacy practice and education. , 2015, Research in social & administrative pharmacy : RSAP.

[36]  Anke Oenema,et al.  Use and Effectiveness of a Video- and Text-Driven Web-Based Computer-Tailored Intervention: Randomized Controlled Trial , 2015, Journal of medical Internet research.

[37]  Blogging and breast cancer: Narrating one's life, body and self on the Internet , 2014 .

[38]  Peter Johannes Schulz,et al.  The Effect of Social Support Features and Gamification on a Web-Based Intervention for Rheumatoid Arthritis Patients: Randomized Controlled Trial , 2015, Journal of medical Internet research.