Presentation at FACT Liverpool - March 17th 2009 Social Media and Healthy Environments What are the needs within healthcare and the environment that could be better served by social technology systems / social media? What is the role of the arts/design and social sciences to better understand the medicalization of cyberspace and to foresee its development

1. SOCIAL MEDIA FOR HEALTHY
COMMUNITIES
Michael Hardey
Hull/York Medical School and Dept of Social Sciences
University of Hull

2. HEALTHCARE IN 21C
The third industrial (and

therefore, healthcare) revolution
is driven by citizens, IT and
knowledge. Professionals are by
and large two decades off the
zeitgeist and this is not restricted
to healthcare, it’s seen across all
professions.’
‘In the past we’ve given

knowledge to clinicians who’ve
then passed it on to
patients, now our principles are
that we give knowledge to
patients and give them the
opportunity to discuss it with
clinicians
Sir Muir Gray – Chief Knowledge Officer, NHS.
www.worldhealthcareblog.org/2008/03/12/citizens-
knowledge-and-the-appropriate-use-of-technology/

3. NHS HEALTHSPACE
Better information, better
choices, better health (NHS
2004)

4. INTRODUCING JOHN
John (40) has diabetes. He has registered a profile of interests
on HealthSpace, his own secure personal health organiser on
the internet. Via HealthSpace, he regularly receives updates
about diabetes and consults his online self-management training
course and interactive care plan. He has setup his mobile so (via
a blue tooth wristwatch) it keeps a check on his blood pressure,
cholesterol and blood-sugar levels. John’s mobile also keeps
track of his location, monitors his activity level and prompts him
to do his daily run. At home John’s ‘smart’ fridge keeps track of
his food and orders that it places with Tescos. Strain gauges in
his shower floor check his weight, sensors in the toothbrush
monitor the composition saliva. Infrared transmitters and
sensors also check the state of his gums. The ‘intelligence toilet’
has a urine analyser and checks such things as sugar levels,
albumin levels and so forth. All this data is added to his NHS
Care Record, and checked against past results. Software sorts
the data and informs John every day about his health status.

6. JOHN IN THE COMMUNITY
John works in local government and his employer has given him the added
benefits of the ‘healthy employer’ initiative. This means that the canteen
has a lunch ready for him, devised from HealthSpace data sharing, and the
coffee machine limits him to only one cappuccino (low fat) a day.
However, being rejected by the lift, because he benefits from the a daily
walk up the stairs can be irritating.
John has been know to spend too long in the local pub but the
publican, through ‘pubnet’, knows that has he is only allowed to be to drink
up to 3 pints a week. The pub has signed up to the ‘healthy pubs’
initiative, which like the ‘healthy supermarket’ initiative shares information
with HealthSpace.
The city CCTV system also helpfully tracks John and he knows it will get his
mobile to warn him if he happens to stray into a pub at the weekend. In any
case CCTV facial recognition software will send data to the pub’s tills
making an alcoholic drink expensive for John. A benefit of the ‘Your
health, Your Lifestyle’ policy is an additional tax that is automatically added
to items so that people like John are encourage to consume healthily and
responsibly.

8. JOHN’S LEISURE TIME
Like many people John lives in a ‘Healthy City’ where real time data
from pollution monitoring stations are streamed to mobile phones
that can warm the owner if air conditions, where they are, falls
below optimal levels for them. The newly available (in the UK) crime
maps helped John choose a home in an area he felt would be safe
for himself and his kids, when they came over at weekends.
Wanting to be a good parent John has signed up to the gallery and
amenities information alerts system that prompts him if there is a
new exhibition or if he has not visited a particular museum in the
past month. Graffiti can be a problem and John has recently posted
a picture of some near his home on a council Web site to ensure it
will be cleaned off.
John always uses his store card and credit card when he is
shopping and out in the city. He often checks the ‘you might like to
try this’ suggestions on his MacBook before he goes shopping.
Experian uses code to sort all the data from John and ‘people like
John’ so that it can offer recommendation that help reduce the risks
of making the wrong consumer choices. However, John usually
checks the community health restaurant map that tags restaurant
details of health reports

10. JOHN’S SOCIAL LIFE
In common with others John uses YouSpace as his SNSs. The
official UK SNS, YouSpace makes it easy for him to pay his TV
licence, manage his ‘GreenBin’ waste allowance and leave helpful
comments about his experiences of government services.
However, he is careful leave nice comments about his GP just in
case he might have to wait longer to see him - like his mate Dave
(who posted a critical note about Dr. Smith’s odd sense of humour
and lack of empathy). Being currently single John is a member of
DateMe, which is a part of the ‘healthy relationship’ initiative. This
takes much of the effort out of creating a profile as it is partly
generated by HealthSpace and YourSpace data. John’s data is
processed together with other members’ data to achieve the optimal
healthy relationship matches. Following the inter-departmental
database sharing policy John’s dates know that he has a good
sexual health record and no history of relevant criminal activity.
Despite a number of dates John has not ‘clicked’ with anyone so
has made some use of the ‘sexual exercise’ material that
HealthSpace data has already downloaded from iTunes onto his
Apple TV device.

12. PEOPLE LIKE JOHN
Do not want to be dependent on ‘services’ however

well delivered
 Do want the tools to do the job themselves
 Do want a focus on the person not the condition
 Expect to use and contribute to – blogs, wikis, user
review sites e.g.
‘iwantgreatcare’, ‘ratemd’, ‘NHSChioces’

13. JOHN’S MUM IS ALSO SHARING DATA…

14. PEOPLE NOT LIKE JOHN?
Want to be cared for

 Do not use information technologies
 Expect practitioners to understand when and how
they can self-manage and support them to do so
 Risk becoming ‘system outcasts’ e.g. less ‘good’
services for those not engaged with social media -
as those like John experience better services

15. THE TWO FACES OF JOHN
Surveilled subject Self-managing individual
Constraints – ‘a puppet of the system’ Choices and personalisation


Volunteered data sharing

Dataveillance

Public services orientated to people -

Public services orientated to policy,

not conditions
services, and targets
Opt in settings

Default settings to service provision

Contributes user-generated – controls

User- generated information ‘risky’ - data
 own data
useful
Sensibility of participation – user led

Sensibility of top down – collaboration

expert/professional led health Service users as productive participants

– innovators
Service users as patients/clients

Professionals as :

Professionals as : experts with access to

advocate, navigate, counsel, risk
abstract systems, gatekeepers, assess, broker, design
providers of information and services
‘Share data and I will choose what and

‘Give us your data - we care for you’
 when to share and who to collaborate
with’

16. FINALLY
These slides will be

posted to ‘slideshare’
My email is:

michael.hardey@hyms.a
c.uk
Related forthcoming

paper ‘informatisation of
welfare’ in British Journal
Of Social Work – special
issue on new
technologies