Research paper Pre-Msc BA CM
How can social media be utilized to improve
patient care and experience in the doctor’s
office?
Institution: Rijksuniversiteit Groningen Programme: Pre-Msc BA CM
Course: Research paper for Pre-Msc BA CM 2016-2017 Tutor: Edin Smailhodzic
Author: Mathijs Hatt Student number: 1998757
Date: 25-05-2017 Phone: 0611168440 E-mail: j.n.hatt@student.rug.nl
1. Introduction
In recent years, social media has made a major uprise among the public (Pinho-Costa et al., 2016). Forrester Research states that 75% of internet users have used social media in the second quarter of 2008 for a multitude of purposes, ranging from joining social media networks to reading blogs. This indicates a significant rise in internet users engaged in social media from 56% in 2007 (Kaplan and Haenlein, 2010). With so many consumers of
healthcare already using the internet for health-related issues, using social media to communicate with patients might seem appealing.
Even though the internet is a relatively new medium for both seeking and delivering healthcare, its use is rapidly increasing (Berry, Seiders & Wilder, 2003). Social media has already started to affect healthcare systems (Koumpourus, Toulias & Koumpourus, 2015). It is increasingly used to share information between practitioners, researchers and patients alike (Pinho-Costaet al., 2016). Research has shown that 78.5% of healthcare consumers are seeking for information concerning healthcare on the internet, 62% look for advice on health and 53,2% look for a specific product or service (Koumpourus et al., 2015).
A literature review conducted by Griffiths, Lindenmeyer, Powell, Lowe and Thorogood (2006) has revealed several benefits that may be enjoyed by both parties, being the healthcare consumers and the healthcare deliverers. These advantages are cost reductions of spreading information, increasing convenience for healthcare consumers, reducing the cost of
healthcare services, the reduction of the isolation of users, increased timeliness of information and the reduction of stigma.
It may thus seem appealing to use, but also comes with major drawbacks. For example, blurring between professional and personal personas may occur (Huby & Smith, 2016), ethical issues regarding patient confidentiality and protection could arise (Adams, Van Veghel & Dekker, 2015) and serious policy changes may be required for the healthcare instance (Rice, 2013).
First, a literature review will reveal insights regarding known applications of social media in healthcare. The literature review will also give an in-depth look of the known advantages and disadvantages of using social media in healthcare. Then, the used methodology will be explained. The theoretical findings will form the basis for the interview questions. These interviews will be held with three practitioners of doctor’s offices to establish how they perceive the utility of social media in healthcare. The results chapter will then show what the findings are, deriving from the interviews that were conducted. Finally, the researcher discusses the findings, implications and limitations of this research in the discussion chapter. The collected information will be used to find answers to the following research questions: ‘’How do doctors perceive the use of social media in their doctor’s office to improve patient care and experience?’’
The following sub-questions are answered to get a complete answer to the initial research question:
‘’What purposes do doctors identify for using social media in the doctor’s office?’’
2. Literature review
This chapter will provide an overview of the available literature regarding the use of social media within healthcare. First, the possible, known applications of social media will be explored, followed by the recorded advantages and disadvantages of social media within the healthcare sector.
2.1 Basic definitions
It is important to first define what social media is and what social media is not, to avoid confusion. The Organization for Economic Cooperation and Development states that, for something to be considered User Generated Content, or what is usually referred to as social media, it should fulfil three requirements. First, it must be published on a publicly accessible website or social media platform, which rules out e-mail and instant messages. Secondly, it should show a certain amount of creative effort, ruling out replications of already existing content, such as reproducing a newspaper article. Lastly, it must be used outside of professional routines and practices, which excludes all content created with a commercial intent (OECD, 2007). In more technical terms, Kaplan and Haenlein (2010) define social media as a group of internet-based applications that build on the ideological and
technological foundations of Web 2.0, and allow the creation and exchange of user-generated content. In this paper, social media refers to internet-based tools that allow individuals and communities to gather and to communicate, by sharing their ideas, information, personal messages, images and other content, or even to collaborate in real-time with other users (Peck, 2014; Chauhan, George & Coffin, 2012).
2.2 Applications of social media
Recent research has indicated multiple possible applications for social media in healthcare (Moorhead et al., 2013; Lim, 2015; Griffiths et al., 2006). It can be used to provide the patients with real-time information regarding emergency medical services (Steele, Adcock & Steel, 2016). This will allow the public to access this information anywhere and anytime when an emergency arises. Besides emergency situations, it can also be used to spread
general health information among the public (Denecke & Nedjl, 2009), patients (Wicks et al., 2010) and other healthcare professionals (Denecke & Nedjl, 2009). Another way to utilize social media for medical practitioners is professional networking. Research has indicated that among practitioners, the most popular social media sites are ones where they can participate in online communities, listen to experts and network and communicate with colleagues regarding patient issues (Househ, 2013). These media are used for clinical purposes, but also for discussing matters of politics, ethics, practice management, career strategies, and even dating within the medical environment (Grajales, Sheps & Ho, 2014).
their progress (Ventola, 2014). Additionally, medical practitioners can use social media to promote healthcare education (Dizon, Graham & Thompson, 2012). Social media can also be used as a source of organizational promotion. Studies have shown that 57% of patients in the United States indicated that a hospital’s presence on social media would influence their decision regarding which hospital’s services to consume, and 81% of patients indicated that a hospital’s use of social media indicates that the hospital offers leading technologies in their services (Peck, 2014). Around 70% of United States healthcare institutions are present on some sort of social media. Of these, about 12,5% indicated that they managed to attract new customers using social media (Househ, 2013).
Social media is also already being used to improve clinical education (Von Muhlen et al, 2012). For example, it is utilized to teach medical students about issues of communication, privacy and professionalism (Peck, 2014). A survey indicated that 38% of pharmacy faculty members use Facebook for teaching purposes, for example, for discussion purposes on a Facebook page. Twitter is also being used to participate anonymously in class discussions, and 80% of participants said they shared opinions and ideas they would otherwise have never shared (Grindrod, Forgione & Tsuyui, 2014).
Patient care can also be improved with the use of social media. Physicians in recent years have had a growing interest for communicating and interacting with their patients online. 60% of physicians indicated that they were in favour of using social media for this, mainly to educate patients, monitor their health and to encourage behavioural changes (Househ, 2013). For example, Georgia Health Sciences University offers a platform to patients called
WebView, through which the patients can ask their physicians questions (Chauhan, 2012). Lastly, it is used to facilitate public health programs. For example, social media can be used to track the progress of (natural) disasters and facilitate a response, as is done by the Red Cross (George, Rovniak & Kraschnewski, 2013).
2.3 Advantages of social media
2.4 Disadvantages of social media
However, there are also some major disadvantages to using social media in healthcare. The first and possibly biggest challenge of using social media in healthcare by doctors, is patient confidentiality and privacy. A multitude of studies pointed out concerns regarding privacy, confidentiality and data security (Moen, Smørdal & Sem, 2009; Nordqvist, Hanberger, Timpka & Nordfeldt, 2009). Often, social media users are not aware of the risks of disclosing personal information on social media and of communicating harmful or incorrect advice (Moreno, Parks & Richardson, 2007). According to Moorhead et al. (2013), to properly use social media in healthcare, ‘’regulatory and security issues must be addressed to broach a way forward for best-practice that allows the benefits of social media to be utilized yet still protects the patients’ privacy and to therefore improve use of these media in routine clinical care’’.
Another main issue with social media in healthcare is the quality and reliability of information, as pointed out by a meta-analysis of literature by Moorhead et al. (2013), as social media is informal and unregulated. The large amount of information that is made available to the users through social media and the possibility of inaccurate information posted further contributes to this problem. As noted by Ventola (2014), while evidence-based medicine tries to de-emphasize anecdotal reports, social media tends to emphasize those, relying on individual patient stories to expand and spread medical knowledge.
Furthermore, the possibility of posting unprofessional content that is harmful to the physician or institution is a considerable risk (Peck, 2014). First impressions are easily made, and by expressing personal values and ideas on social media, this has the potential to damage a physician’s or institute’s reputation. Furthermore, some patients may leave unfavourable and potentially damaging reviews or posts regarding a certain healthcare institute or physician, also damaging their reputation (Faman, Snyder & Worster, 2013).
3. Methodology
The following chapter will describe the research method that has been used to conduct this research. This includes the method of data collection, the way in which validity and reliability will be secured, the criteria for the research subjects and the method for data analysis.
3.1 Research method
To successfully complete this research, a qualitative method of research was used. The reason for this is that in-depth, expert information and opinions are needed. Qualitative research bases its data collection on qualitative information. This means that it does not look for hard data in the sense of numbers, but instead focuses on qualitative information. This can range from narratives and sentences to simply just words (Blumberg et al., 2014). Another reason for using a qualitative approach, is that the researcher simply does not know beforehand which topics are of the most relevance to the research subjects. A qualitative approach leaves room for adjustment during the interview for both the researcher as well as the research participant.
To conduct this qualitative research, semi-structured interviews were used. The key advantage of semi-structured interviews includes the ability to structure the interview and decide the topics of discussion, while still allowing the interviewee to follow and explain their own thoughts (Blumberg et al., 2014). Semi-structured interviews are also preferred over structured interviews, as the researcher should not reveal all the theoretical findings of the literature research. The reason for this is that, if the researcher were to announce all the applications of social media in healthcare beforehand, the participants would be more likely to just agree, rather than use their own logic, reasoning and insights to answer the research question. As it was vital that the researcher unveils what the participants deem important themselves, it was desirable to not introduce all these findings through a structured interview. The goal of these semi-structured interviews is to extract the insights and knowledge that the interviewees have regarding the topics of research. These interviews will be held in a face-to-face manner. The audio of the interviews was recorded and notes were made, to best preserve the information. It is, however, very time consuming to record interviews on tape. One hour of tape requires between five and six hours to transcribe (Bryman, 2001).
The most important reason for conducting the interviews face-to-face, is that in face-to-face interviews, the researcher can notice social cues, such as voice, intonation and body
language, adding additional information to the verbal answer of the interviewee. Another advantage is that there is no significant time delay between the researcher’s question and the interviewee’s answer, meaning that the researcher can directly respond to or act on what the subject says or does. This will also lead to more spontaneous answers from the interviewee, and may thus be less what is socially expected of them, but more reflective of how they really feel (Opdenakker, 2006).
3.2 Validity and reliability
To solidify the quality and trustworthiness of this research, it is important to look at how validity and reliability will be ensured. According to Roberts and Priest (2006), reliability and validity are ways of ‘’demonstrating and communicating the rigour of the research processes and the trustworthiness of research findings’’.
Reliability is the trustworthiness of the procedures and data that are generated (Stiles, 1993). Bryman (2001) further expands on this, stating that validity is the extent to which the results of a study or measure will be the same when repeated in different circumstances. The validity of the study is the extent to which the research tools, in this research the interviews, measure the factors that are being researched (Punch, 1998).
The ways in which validity and reliability were ensured can be found in appendix 2. 3.3 Research participants
Three doctors were interviewed for this research. These doctors had to be general
practitioners in a doctor’s office that conduct examinations on patients. These interviews lasted for around twenty minutes and were conducted in May of 2017.
To select appropriate participants for this research, a few key criteria were set beforehand. Firstly, the subject must be a general practitioner as a doctor in a doctor’s office. As this research regards only doctor’s offices, this is a rational criterion. Secondly, the subject must be on some sort of social media. If this was not the case, the participants might not know anything about social media and no insights or ideas could then possibly be extracted from the interview, thus being unable to support this research. These requirements were satisfied with all research participants.
3.4 Data analysis
4. Results
This chapter will display the results of this research for each research sub question and the main research question. The code book that was used for these results can be found in appendix 4, while the transcriptions of the interviews will be attached in appendix 5 and 6. 4.1 Applications of social media
An interesting first insight reveals that none of the doctors interviewed were using social media for health purposes in their practice, even though all of them, at some point, did consider it to some degree.
Regarding applications of social media in doctor’s offices, the one application that stood out was providing medical information to patients. All doctors interviewed named this as an application and stressed the importance of this. They all stated that information can be easily spread to patients through social media, for example, by simply answering questions. A possible application could be e-consultation. Furthermore, all doctors agreed that social media could also be used to share practical information with their patients, such as opening times, the accessibility of consultation hours and when they are closed.
Two out of three of the doctor’s mentioned that social media could be used for organizational promotion in some way. One idea was Tweeting ‘’STD-tests 50% off this week’’ to get people familiar with their practice. The same two doctors noted that social media could very well be used to connect with colleagues and discuss medical issues that they can’t figure out themselves. Lastly, these two doctors added that social media could be used for general, public health issues, such as announcing that the hay fever season has started again.
Of all applications, two doctors agreed that providing healthcare education or information to their patients would be the most relevant use of social media. Another doctor stated that providing the patients with medical and practical information would be the most important application. Evidently, all doctors agree that providing information in some form is the most important application.
4.2 Advantages of social media
All three doctors interviewed agreed on a multitude of advantages of social media. Firstly, all doctors agreed that the increased accessibility of social media is a major advantage. As noted by one doctor, a lot of people still feel embarrassed discussing certain medical issues with doctors face-to-face, and feel a lot more confident and secure asking those questions online. Furthermore, one doctor stated that the reach of a practitioner’s office will be greatly
Two of the three doctors named another key advantage, being the better fit with younger people. One of the doctors stated: ‘’Social media just fits with younger people better. Most students just don’t have time anymore to come by the doctor’s office to ask a simple question’’.
Strikingly enough, none of the interviewed doctors mention anything about the nearly non-existent cost of using social media. This is an interesting observation, as it is one of the most important reasons for hospitals to use social media.
4.3 Disadvantages of social media
As is customary in healthcare, patient privacy and confidentiality were indicated by all three doctors as the key challenge of using social media as a doctor’s office practitioner. The doctors noted that it is impossible to know where your personal and medical information ends up and who ends up reading it. An important thing to note is that none of the doctors truly had a solution for this problem. One doctor did note, however, that if the medical software that doctor’s offices use, such as patient information, could somehow be connected to the patient’s social media, it might be possible to ensure the privacy standards are secured, but it was unclear to her if this was even possible.
Additionally, all three doctors stated that if doctor’s offices were to use social media, it is likely that they will be flooded with questions. As one doctor mentioned: ‘’The question is whether you get overwhelmed with questions that people normally wouldn’t ask, about things that they’d normally just wait for to be over. However, the barrier of asking a question on social media is significantly lower than making a phone call or visiting a doctor’s office, and thus people will probably ask you a lot of questions that they normally would’ve just waited out’’. Another doctor noted in the same fashion that you will probably get a lot of questions, but that it would be ‘’Hard to live up to what you promise. If you enable people to ask
questions on social media, you will probably get a lot of questions, and if you allow this, then you also must stay true to your word and reply to them all’’.
5. Discussion
This chapter offers the discussion of this research, the contributions that this research has made to practice, the limitations of the conducted research and indications for further research.
First, each research question is briefly answered regarding what this research has found and what previous literature indicated.
‘’For what purposes can social media be used in the doctor’s office?’’
Many applications were named by the doctors that were interviewed. The most important ones were the spreading of information, be it educational, such as about certain diseases, or practical, such as opening times and consultation hours, as also pointed out by Moorhead et al. (2013), Wicks et al. (2010), Denecke & Nejdl (2009) and Pinho-Costaet al. (2016). All doctors agreed that the spreading of information to patients, for whatever purpose, was the best practical use for doctors’ offices. Promotion for the practice was also named as a plausible way to use social media, as also described by Peck (2014) and Househ (2013). ‘’What are advantages of using social media in the doctor’s office?’’
The key advantages that were named by the doctors were the increased accessibility to all kinds of users, either for convenience, as pointed out by Adams (2010) and Chou et al. (2009), or for questions that patients might find embarrassing to talk about face-to-face, as was also established by Griffiths et al. (2006). Furthermore, as also found by Griffiths et al. (2006), all doctors agreed that the timeliness and availability of social media was a key advantage, as people could use social media 24 hours a day to ask questions or find
information. Lastly, two of the doctors stated that social media better fits their target group, being young people, as using social media is just a better fit to their lifestyles. Using the internet in healthcare to connect to younger people was already found to be desirable by Iafusco et al. in 2000.
‘’What are disadvantages of using social media in the doctor’s office?’’
Finally, the main research question was ‘’How can social media be utilized to improve patient care and experience in the doctor’s office?’’
Based on the results from this research, it can be established that it will be very hard to use social media for medical purposes, mainly due to privacy and confidentiality concerns, as also pointed out by Moorhead et al. (2013). It can, however, be used to spread general
information about certain health-related issues and diseases, educational stories or videos and to share practical information about the practice, but not so much for communication between patients and doctors.
5.2 Contribution for practice
This paper has indicated a few practical implications for practitioners. The conducted research offers insights for doctor’s offices regarding how to and how not to utilize social media. The main contribution is the finding that social media should, for now, not be used for medical information or e-consulting, as this raises serious issues with privacy. However, it can be used for spreading general information, educating patients about certain diseases and sharing practical information about the practice. Social media can also very well be used for promotional purposes. An additional contribution is the fact that making it so easy to ask questions for patients, might cause a healthcare institution, like a doctor’s office or hospital, to be flooded with questions that people would’ve not asked otherwise.
5.3 Limitations
This research, however, includes a few limitations. The first limitation, as also noted by Miller and Tucket (2012), is that this paper focuses solely on the use of social media in the healthcare sector, in this case particularly on doctor’s offices. This makes it hard, or even impossible, to apply to other industries. The main reason for this is that the healthcare industry is an unusual sector, in terms of the privacy concerns it may generate regarding the use of social media (Goldfarb and Tucket, 2012).
The number of research participants, being only 3, is a second limitation of the conducted research. As qualitative research is already very hard to generalize, having only three participants makes this even harder. Although this research has come up with a couple of interesting key findings and implications, more extensive research is needed to scientifically conclude the degree to which these findings are applicable to all doctor’s offices.
A final limitation is the time window that the researcher had for interviewing. As
5.4 Further directions for research
The key learning point from this research is that the concern for privacy is the biggest
roadblock holding back the use of social media in doctor’s offices. Therefore, it is interesting to further research how this challenge can be overcome. Furthermore, as the results might not be directly applicable to all doctors’ offices due to the amount of research participants, it might be desirable to conduct this research in a more extensive manner, to establish whether these results are generalizable.
5.5 Conclusions
In conclusion, none of the interview practitioners were using social media for health purposes. Spreading medical and practical information was found to be the most important application, while organizational promotion was the second most important. For the advantages, accessibility, timeliness and availability of information was deemed the most important, in addition to social media fitting better with young people than using the telephone to make an appointment. As disadvantages, patient privacy and confidentiality of patient information were pointed out to be the biggest problem. Furthermore, the accessibility of social media was also stated as a possible disadvantage, as it might floor doctor’s offices with questions that patients would have otherwise solved themselves. All research
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Appendix 1: Interview Guide
IntroductionPart 0: Warming up
Could you tell me who you are and what you do? To what extend are you familiar with social media?
Are you a member of social media communities, such as Facebook, twitter LinkedIn? Have you ever considered using social media professionally?
What about using it for your doctor’s office? Part 1: Applications of social media
What possible applications do you recognize for social media in doctor’s offices? Which of these applications would be the most useful to you?
Part 2: Advantages of using social media
Which advantages do you recognize from using social media in the doctor’s office? How do you experience this? How would this come into play?
How important do you rate these advantages? Which one do you value the most? Part 3: Disadvantages of using social media
What challenges could arise from using social media in the doctor’s office? How could you counter these challenges?
Which is the hardest challenge to overcome? Part 4: End of interview:
Do you have any additional information of which you think it might be important for my research, that I forgot to bring up in this interview?
Appendix 2: Ensuring validity and reliability
To protect the reliability of this research, a few preventive measures will be taken. Firstly, all interviews are recorded on tape, in addition to making notes. This will allow the researcher to better participate and listen to the interviewee, and transcribe the interview afterwards. The taking of notes in addition to recording, will help check if all questions have been answered and provide a backup if the recording device is not working (Opdenakker, 2006). Secondly, the same interviewer conducted all interviews, to remove the chance of different
interpretations and asking different questions, or asking questions differently.
Appendix 3: Data Analysis
The way in which data was collected, analysed and organized can be found in the table below. This analysis was conducted as described by Lacey & Luff (2009) and Noble & Smith (2014). The basic codebook is made before the interviews, based on what important topics were found in the
literature research. The interviews might add additional codes to the codebook, if topics are named that were not found in literature.
Step Description
Interviewing participants Conducting interviews with the research participants.
Transcribing interviews Tape-recording the interviews and later writing out all that was said in the interviews.
Organizing data Number the transcriptions, remove any evidence that might indicate someone’s identity, making hard copies of transcriptions, make backups of transcriptions.
Coding Assigning codes to important statements in the interviews by using the codebook, counting the number of times each code is used to identify which topics are deemed important and which are not. Comparing The codes will be transformed into a results section and be
Appendix 4: Codebook
Code Description Example Total times
coded in all interviews Number of unique interviews it was coded in Applications of Social Media: Providing practical information regarding practice ASC/PI Providing information regarding opening times, consultation and vacation ‘’Practical information such as opening times, practice information, the accessability of the consultation hour, the whole practical side to it.’’ 111 2 Applications of Social Media: Providing medical information to patients ASC/MI Providing information in reply to questions ‘’What we do is provide an e-consult, patients can request a consult with questions.’’ 111 3 Applications of Social Media: Professional networking ASC/PN Connecting with colleagues and discussing medical or practical issues ‘’You [as a physician] could send a picture of a condition you can’t figure out and have your colleagues take a look at it and provide you with their insights.’’ 11 Applications of Social Media: Increasing accessability ASC/IA Enabling of reaching a larger audience Applications of Social Media: Promoting healthcare education ASC/PE Providing unsolicited information for educational purposes ‘’You could provide education or information to your patients.’’ 111 Applications of Social Media: Organizational promotion ASC/OP Promoting the practice or institution to the public
‘’You could, for example, tweet something like ‘STD-tests 50% off this week’.’’
Applications of Social Media: Improving patient care ASC/PC Providing extra benefits, by any means, to patients using social media Applications of Social Media: Public Health programs ASC/PH Improving the public health and safety
‘’You could, for example, make posts stating that the hayfever season has started.’’ 1 Advantages of social media Cost reductions ADS/CR Lowering costs for administration and healthcare Advantages of social media Higher availability of information ADS/AI Have information more easily available ‘’People could be lying in bed at midnight and ask a question or look for a specific answer.’’ 111 3 Advantages of social media Better accessability to all kinds of people ADS/BA Be able to reach more groups of people, regardless of race, age, education and illness
‘’People still find it difficult sometimes to ask questions to a physician [face-to-face], doing it through social media is a way lower barrier.’’ 111 3 Advantages of social media Better fit with younger people ADS/BF Connect better with younger people by using their ways of communication ‘’Social media just fits with younger people better. Most students just don’t have the time anymore to come by the doctor’s office for questions.’’ 1111 2 Advantages of social media Timeliness ADS/TI Being able to provide information in a quicker fashion ‘’Social media is usually just faster than for example waiting on the phone while you’re being kept on hold.’’
111 3
Disadvantages of social media
The privacy and confidentiality regarding patient personal and
‘’That [privacy] is the big problem. You never know where your
Patient privacy and confidentiality DSM/PC medical information [personal and medical] information ends up.’’ Disadvantages of social media Quality and reliability of information DSM/QI The possibility of faulty information or information of poor quality being spread
‘’It’s easy to scare yourself with information you find, because you never know how accurate it is.’’ 11 1 Disadvantages of social media Damage to reputation DSM/DR Harmful content to a practitioner or healthcare institution ‘’It’s entirely possible that a physician has an unpleasant experience with a customer and they [the patient] go writing very negative reviews or social media posts about it.’’
1 1 Disadvantages of social media Blurring of personal and professional personas DSM/BP The blurring of boundaries between a physician’s personal and professional life Disadvantages of social media Overload of questions DSM/OQ Because of the low barrier to use social media, patients may ask an abundance of questions that they normally wouldn’t
‘’The question is whether you get overwhelmed with questions that people normally
wouldn’t ask, for things [small health issues] that normally just pass. The lower the barrier to ask questions, the more questions people are going to ask, while before, people would just kind of wait until it passed.’’ 111 3 Disadvantages of social media Receiving no monetary benefit for work you
‘’Another issue is: how are you going to get paid
Providing care and information without pay DSM/WP
would normally receive pay for
for your work on social media? It has to be profitable in some way. But if patients can use social media anonymously to contact you, it’s going to be very difficult.’’ Disadvantages of social media Integrating and applying knowledge to own case DSM/IK Being unable to properly apply the knowledge found on social media due to lack of knowledge or experience
‘’Integrating the knowledge that you find [online] is the hard part, you need experience for that. Only if you have been involved in it for a long time, will you be able to correctly use the information.’’
Appendix 5: Interview 1 and 2 transcriptions
Onderdeel 0: IntroductieIn welke mate zijn jullie bekend met social media? Zitten jullie zelf op social media? Facebook. Ik
heb de hele boel, Twitter, Instagram, Pinterest, Facebook, ik heb bijna alles wel, maar ik ben niet heel actief. Nee, ik ook niet. Oke, maar jullie zijn er dus in elk geval bekend mee en weten hoe het
allemaal zit. Ja. Ja. Oke, super. Gebruiken jullie momenteel iets van social media voor de
studentarts, of hebben jullie dat ooit overwogen? We gebruiken het nu niet, ik weet niet zo goed of
we het zouden kunnen gebruiken. De privacy moet eerst beter worden. Dat is een beetje het grote
punt, dat je niet weet waar het allemaal eindigt, waar de informatie eindigt, ik denk dat dat het grootste [problem is]… Want we werken wel heel erg gericht op studenten met, nouja, eh,
e-mailconsult en dat soort dingen, en online inboeken, foto’s sturen, maar dat gaat allemaal met name per e-mail. En social media.. nee. Je zou natuurlijk gewoon kunnen twitteren.. (ja) vandaag in de
aanbieding, de soa-testen bijvoorbeeld.. Ja, of het hooikoortsseizoen is weer begonnen. Ja, want dat zou je natuurlijk gewoon zonder […], dat zou je natuurlijk gewoon kunnen twitteren. Ja, maar Twitter
ben ik dan weer niet zo actief in, dus dat is… Onderdeel 1: Toepassingen van social media
Dan wordt het daar dus weer lastig. Maar het is heel goed dat jullie dit noemen, want dit was even om te kijken van hoe ver zijn jullie bekend met social media, maar best aardig dus. En het eerste onderdeel van het interview is dan ook: welke toepassingen heeft social media binnen huisartsen, en waar zou je het voor kunnen gebruiken? Misschien voor voorlichting. Ja, voorlichting denk ik met
name. Kijk, echt persoonlijk contact, denk ik niet dat dat hem gaat worden vanwege gewoon privacy,
via facebook ofzo persoonlijk contact denk ik niet dat dat heel handig zou zijn. Maar wel in
bijvoorbeeld voorlichting, want je merkt wel dat mensen vaak dagelijks kijken even op hun facebook, en met een beetje leuke filmpjes of dingetjes zou je natuurlijk wel wat kunnen doen met
voorlichting. Dat Is natuurlijk wel wat meer gericht op hoe tegenwoordig mensen zijn en leven. Daarin zou ik nog wel wat zien. Dat klinkt al seen hele geode toepassing. Zijn er zo nog meer dingen die je kan bedenken waarvoor je social media zou kunnen gebruiken om de ervaring of de zorg van de patient te kunnen verbeteren? Nouja, je zou natuurlijk [als huisarts] foto’s van iets raars dat je
ziet, wat je niet weet wat het is, op het internet kunnen gooien en kijken of al je andere collega’s even met je mee willen kijken van wat kan dit nou zijn. Dat je een soort groep hebt van huisartsen… ja. Want je ziet vaak genoeg dingen waarvan je denkt ‘’wat is het eigenlijk?’’ en dat gebeurt je elke zoveel weken wel een keer dat je iets ziet wat je nog nooit eerder hebt gezien na al die Jaren. En soms zie je bepaalde ziektebeelden terwijl een andere college dat nog nooit gezien heeft. Dus daar zou je best wat mee kunnen. Allemaal anoniem, natuurlijk, want dat is altijd een probleem, maar dat kan natuurlijk best. En zonder daar teveel op persoonlijk of detail op in te gaan, hoe lossen jullie dat
normaalgesproken op, als jullie een probleem hebben waar jullie niet uit komen? Je kunt met het
ziekenhuis overleggen, je kunt je collega’s vragen om mee te kijken. Of je laat de patient later terug komen en gaat ondertussen [als huisarts] zelf zoeken. Oke. Zo uit jullie hoofd nog iets dat jullie
zouden kunnen bedenken waarvoor je social media als huisarts kan gebruiken? Met name veel
voorlichting, denk ik. Ja. Foto’s kun je natuurlijk op pinterest zetten. Wat ik heel graag wil is dat dat
thuisarts gewoon gelanceerd wordt in Nederland. Ja, nouja dat is natuurlijk niet echt social media,
maar meer een website waar je van alles op kan zoeken over betrouwbare informatie over
vertellen [thuisarts]? Het is eigenlijk een website, vanuit onze beroepsorganisatie gemaakt met echt de informatie die je in een consult zou krijgen. Dus gewoon betrouwbare informatie en gewoon praktisch gericht, en gewoon niet al te veel informatie en kort en bondig. En daar zijn heel weinig mensen nog bekend mee, en daar proberen we altijd naar te verwijzen. Als er enige vorm is van een manier voor mensen om daar iets op te plaatsen, of vragen te stellen, dan neigt het al snel naar social media natuurlijk. Nee, dat is niet het geval. Wat wij zelf hebben is e-consultant, dan kunnen
mensen zelf een aanvraag voor een consult sturen met vragen, maar echt om informatie uit te wisselen met patienten vind ik het wat minder geschikt, omdat het natuurlijk nogal persoonlijke vragen zijn. Ja, dat kan ik me voorstellen. Van de dingen die jullie net noemen, jullie impliceren het
al, welke toepassing van social media lijkt jullie nou het meest nuttig? Toch wel de voorlichting. Ja,
inderdaad.
Onderdeel 2: Voordelen van social media
Nou, dan wil ik het graag gaan hebben over wat nou de voordelen zijn van het gebruik van social media, welke voordelen brengt dat met zich mee [als huisarts]? Laagdrempeligheid. Mensen stellen
sneller vragen. Ook je aansluiten bij je bevolkingsgroep, de jonge mensen zegmaar. Weet je,
studenten hebben ook geen tijd om naar de praktijk te komen, dus als je om 12 uur ‘s nachts gewoon even een vraag kan stellen, of je gooit iets in een groep waar ook andere mensen mee kunnen denken, dan… En sowieso is het niet meer zo van deze tijd dat mensen alleen tussen 8 en 10 kunnen
bellen bijvoorbeeld. Nee. Precies. Voor afspraken enzo. Dus wat dat betreft ben je dan meer 24 uur bereikbaar per dag. En het is denk ik ook wat makkelijker, wat laagdrempeliger (ja), het is soms toch
nog best lastig om naar een huisarts te gaan om vragen te stellen, nog steeds, voor heel veel mensen. Ja. Zeker als je het eventueel anoniem zou kunnen doen. Ja. Zijn er nog andere voordelen
die jullie kunnen bedenken? Nee, eigenlijk niet. De wereld wordt wat groter dan je eigen praktijkje.
Je kunt wat meer met andere praktijken meekijken en zij misschien ook met jou. Een beter bereik. Ja, maar ook van andere dokters leren, want je leeft heel erg op je eigen eilandje als huisarts, en je doet dingen zoals je ze misschien vroeger geleerd hebt, maar misschien zijn dingen al lang weer veranderd en weer nieuwe inzichten. Je kunt er ook nog wat van leren, denk ik. En hoe belangrijk vindt u deze
voordelen? Welk voordeel hecht u het meeste waarde aan? De laagdrempeligheid denk ik. Ja, ja. Kunt u daar iets meer over vertellen? Waarom vindt u dat het belangrijkste voordeel? Nouja,
mensen hebben het druk tegenwoordig. Ze hebben allerlei andere dingen, en dan kun je gewoon nog even met je huisarts contact hebben, of je kunt vlug even iets opzoeken, … Het past gewoon meer bij
deze tijd. Het sluit beter aan bij wat onze doelgroep nu wil. Oke, duidelijk. Onderdeel 3: Nadelen van social media
Natuurlijk ben ik ook benieuwd: wat vinden jullie nou nadelen aan het gebruik van social media bij huisartsen? Welke obstakels heeft social media voor huisartsen? Privacy, dat is de grootste denk ik.
Ja. En daarnaast natuurlijk, hoe gaan we dat regelen dat je er ook wat voor betaald krijgt uiteindelijk.
denken jullie dan dat het grootste obstakel zou zijn van de dingen die net genoemd zijn? Privacy. Ja, absoluut ja. En hoe zou dat probleem van die privacy verholpen of gereduceerd kunnen worden? Misschien een link met het systeem, want we hebben natuurlijk verschillende huisartsensystemen, dat je iets daarin kan linken, maar ik heb geen idee of dat kan. Ik ben niet iemand van ICT, maar dat is het enige wat ik zou kunnen verzinnen als soort beveiligde lijn, maar volgens mij kan dat niet. Nouja, het idee van social media is natuurlijk dat iedereen kan meelezen. Nee, dus het kan dan volgens mij niet. Ja, dan zou je een soort anonieme facebook pagina ofzo moet
hebben, maar dan weet je ook niet van wie het is, dus dat blijft lastig. Het is bij e-mail al de vraag hoe
Appendix 6: Interview 3 Transcription Onderdeel 0: Introductie
In welke mate bent u zelf bekend met social media? Ja, de gewone dingen natuurlijk. Gewoon, uh, de website.. Ik weet niet precies wat je bedoelt? Nou, dat maakt niks uit, zit u zelf bijvoorbeeld op social media? Bent u zelf actief op bijvoorbeeld facebook? Ja, op Facebook al sinds eind vorige eeuw. En mijn telefoon is ook al van de vorige eeuw, dus ik was wat dat betreft niet echt laat. Ja, facebook, whatsapp, en sms, en weet ik veel wat allemaal wel niet. Twitter doe ik niet aan, dat vind ik een beetje onzin. Oke, dan heeft u dus wel verstand van wat het is en hoe het in elkaar zit. Ja, mensen doen heel veel natuurlijk met het internet tegenwoordig. Het is natuurlijk superhandig. Ja, klopt. Is er op het moment iets van social media voor de huisartsenpraktijk? Bijvoorbeeld een Linkedin, twitter of facebookpagina? Nee, dat vind ik niet nodig. Ik heb gewoon een internetsite en Facebook, ja, dat is zo op het moment. Het is wel zo, als je je open stelt, je hebt bijvoorbeeld artsen in het ziekenhuis die natuurlijk via email, dat gaat hier naar mijn assistenten en die brengen het dan naar mij. Maar als je rechtstreekt toegankelijk bent voor vragen, moet je dat ook allemaal kunnen beantwoorden. En dat kost je al gauw een uur per dag. Dus als je het doet, ja, dan moet je daar ook netjes mee omgaan, en daar moet je wel tijd voor hebben. He dus Facebook, kun je dan vragen stellen als patient, ja, dan moet je [als huisarts] dan ook netjes mee om gaan. Het schept ook verwachtingen en die moet je ook waar kunnen maken. Dus heeft u ooit overwogen om social media te gebruiken voor uw praktijk? Nee, nee. De website en de assistenten. Op de website kunnen ze wel recepten halen, praktische dingen wel, mensen sturen ook wel via de mail naar de assistenten vragen met fotos en dat soort dingen. Maar dan loopt het wel via de assistenten en dat is gewoon een kanaal dat goed loopt. Dus dat is het punt, dat je gewoon waar moet kunnen maken in zon vorm van communicatie. Dat kan inderdaad een goede reden zijn om het niet te doen. Ja, of om het te structureren. Het is gewoon gevaarlijk in ons vak want stel dat je zegt ‘’pijn op de borst, zal het even op facebook zetten’’ en dan zie ik dat misschien na een week en dan kan iemand al overleden zijn. Dus dat moet je dan ook gewoon goed doen. Want anders, ja dan is het gevaarlijk, of kan het gevaarlijk zijn.
Onderdeel 1: Toepassingen social media voor huisartsen
nou u heeft net een aantal toepassingen genoemd waarvoor social media gebruikt kan worden. Welk van die dingen acht u het meest nuttig als huisarts? Informatie natuurlijk. Informatie is altijd belangrijk. Informatie in welke vorm? Nouja, in elk geval de praktijkorganisatie, de toegankelijkheid van het spreekuur, de hele praktische kant. En in tweede instantie wel de ziektebeelden he, vraagjes die opkomen, dat daar adequaat antwoord op komt. Maar dan heeft dat gewoon wel altijd het gevaar dat je verzand in alle informatie waar je niet uitkomt.
Onderdeel 2: Voordelen van social media als huisarts
Wat zouden volgens u dan voordelen zijn aan het gebruik van social media als huisarts? Nou, dat patienten aan relevante informatie komen. En dat is toch wel echt een voordeel. Vindt u dat dan ook het belangrijkste? Ja, ik denk het wel. Kunt u nog andere voordelen bedenken aan het gebruik van social media [als huisarts]? Ja, dat het dan gewoon online kan, zoals nu bijvoorbeeld met de e-mail met de assistenten, dat is vaak toch iets efficienter en sneller, dan wachten op de telefoon als de lijn weer bezet is. Dat is altijd een punt natuurlijk, dat [telefoongebruik] is nooit netjes verspreid natuurlijk.
Onderdeel 3: Nadelen van social media als huisarts
Oke, dankuwel. In verband met de tijd ga ik gewoon even verder naar de nadelen. Wat zouden nou grote uitdagingen of obstakels kunnen zijn aan social media? Nouja, wat ik net een beetje zei natuurlijk, dat je teveel beloofd en te weinig kunt waarmaken, of verwachting schept die je niet kunt realiseren. Bijvoorbeeld dat je niet snel genoeg kan beantwoorden. En dat verkeerde informatie blijft rondslingeren, gelukkig kom ik er wel goed af op die beoordelingssites, maar het komt
natuurlijk ook voor dat collega’s om een of andere reden een lullige ervaring heeft en dat de patient dan hele vervelende dingen op het internet uitstoot. Ja dan is dat niet leuk voor je beeldvorming. Dan ben je daar niet blij mee. Zijn er nog andere nadelen die u kunt bedenken? Wat bijvoorbeeld een heel groot discussiepunt is in de gezondheidszorg is… Ja, privacy natuurlijk. Ja, zeker. Dat moet natuurlijk wel heel erg gewaarborgd zijn. We zijn er zelf wel heel voorzichtig in. En van de nadelen die u heeft genoemd, wat lijkt u het grootste obstakel? Nouja, dit [privacy] punt is natuurlijk wel een grote. Als dat niet goed gewaarborgd is, van privacy, is dat een hele gevaarlijke. De vraag is in hoeverre je dat kunt tegengaan. Kunt u zo een manier bedenken om dat gevaar tegen te gaan of beperken? Nouja, we zijn zelf natuurlijk altijd super voorzichtig met onze informatie, alles
afgeschermd, dus dat in ieder geval, alle medisch geheime informatie moet heel veilig verstuurd worden. Nouja en goed, en als tweede dan wel dat mensen natuurlijk onjuiste informatie krijgen of kunnen verspreiden.
Onderdeel 4: Afsluiting
