This document discusses characteristics of online healthcare consumers and the implications of internet and social media use. It describes that about half of US adults own smartphones and use them to look up health information online. It discusses benefits and risks of various technologies like email, texting, videos and social media. It also examines ethical issues around unreliable health information online and privacy breaches. Finally, it analyzes the role of nurses in ensuring effective health information dissemination and enhancing provider-patient communication through technology.

1. Internet, Social Media, &Internet, Social Media, &
Healthcare ConsumersHealthcare Consumers
Stephanie BarreraStephanie Barrera

2. Objectives:Objectives:
1.1. Describe characteristics of online consumers.Describe characteristics of online consumers.
2.2. Discuss the benefits and risks of social media.Discuss the benefits and risks of social media.
3.3. Examine the implications of the internet and social mediaExamine the implications of the internet and social media
on health consumers.on health consumers.
4.4. Identify ethical issues related to the use of internet andIdentify ethical issues related to the use of internet and
social media.social media.
5.5. Analyze the role of the INS in the use of internet andAnalyze the role of the INS in the use of internet and
social media.social media.

3. Who are the OnlineWho are the Online
Consumers?Consumers?
About half of US adults own a smartphoneAbout half of US adults own a smartphone
(Pew Research Center’s Internet & American(Pew Research Center’s Internet & American
Life Project, 2012)Life Project, 2012)
17% of these use a cell phone to look up17% of these use a cell phone to look up
health of medical information (Purcell, 2012)health of medical information (Purcell, 2012)
Minority Internet users are more likely thanMinority Internet users are more likely than
non-Hispanic whites to use social sites, watchnon-Hispanic whites to use social sites, watch
vides, send/receive texts or emails (Pewvides, send/receive texts or emails (Pew
Internet & American Life Project, 2012)Internet & American Life Project, 2012)
55% of online users only access the internet55% of online users only access the internet
with their phones (Pew Research Center’swith their phones (Pew Research Center’s
Internet & American Life Project, 2012)Internet & American Life Project, 2012)

4. E-mailsE-mails
Email is the e-communication technologyEmail is the e-communication technology
most pervasive in healthcare (Weaver,most pervasive in healthcare (Weaver,
Lindsay, & Gitelman, 2012)Lindsay, & Gitelman, 2012)
5% of adults ages 18-64 have5% of adults ages 18-64 have
communicated with a healthcare providercommunicated with a healthcare provider
by email in the past 12 months ( Cohen &by email in the past 12 months ( Cohen &
Strussman, 2010)Strussman, 2010)
Allow for “continuous access and moreAllow for “continuous access and more
active participation in patients’ healthcareactive participation in patients’ healthcare
by patients and families (Mann, Lloyd-by patients and families (Mann, Lloyd-
Puryear, & Linzer, 2006)Puryear, & Linzer, 2006)
14% of US Internet users have signed up to14% of US Internet users have signed up to
receive emails about health or medicalreceive emails about health or medical
issues (Fox, 2011)issues (Fox, 2011)

5. Text MessagingText Messaging
The most convenient use of texts is to sent patients reminders orThe most convenient use of texts is to sent patients reminders or
alerts (Weaver, Lindsay, & Gitelman, 2012)alerts (Weaver, Lindsay, & Gitelman, 2012)
Has the ability to enable communication one-to-one or largerHas the ability to enable communication one-to-one or larger
audiences such as with mass/group texting (Weaver, Lindsay, &audiences such as with mass/group texting (Weaver, Lindsay, &
Gitelman, 2012)Gitelman, 2012)
According to Weaver, Lindsay, & Gitelman (2012), some potentialAccording to Weaver, Lindsay, & Gitelman (2012), some potential
benefits to healthcare are:benefits to healthcare are:
1.1. Convenience -consistently on hand and switched on.Convenience -consistently on hand and switched on.
2.2. Ubiquity- most have texting capabilityUbiquity- most have texting capability
3.3. Immediacy- recipients most likely to respond right awayImmediacy- recipients most likely to respond right away
4.4. Communication- two-way communication capabilities givesCommunication- two-way communication capabilities gives
opportunity for direct engagementopportunity for direct engagement
5.5. Monitoring- can be used to monitor/report symptomsMonitoring- can be used to monitor/report symptoms
Measurability- results can be tabulated and measuredMeasurability- results can be tabulated and measured
Dissemination- used for emergency alertsDissemination- used for emergency alerts
Multimedia- can include links to audio, video, or websitesMultimedia- can include links to audio, video, or websites

6. VideosVideos
71% of US adults using the internet are using71% of US adults using the internet are using
video-sharing sites (Center for Diseasevideo-sharing sites (Center for Disease
Control and Prevention, 2011)Control and Prevention, 2011)
YouTube is most popular site with 490 millionYouTube is most popular site with 490 million
monthly visitors in the year 2011 (Center formonthly visitors in the year 2011 (Center for
Disease Control and Prevention, 2011)Disease Control and Prevention, 2011)
Many healthcare organizations provideMany healthcare organizations provide
informative teaching videos for consumers oninformative teaching videos for consumers on
their websites such as the CDC, Mayo Clinic,their websites such as the CDC, Mayo Clinic,
Juvenile Diabetes Foundation, and NIHJuvenile Diabetes Foundation, and NIH
(Center for Disease Control and Prevention,(Center for Disease Control and Prevention,
2011)2011)

7. Electronic Health RecordsElectronic Health Records
Part of the Meaningful Use requirements as per thePart of the Meaningful Use requirements as per the
Center for Medicare and Medicaid ServicesCenter for Medicare and Medicaid Services
(Blumenthal, 2009)(Blumenthal, 2009)
Allow for nurses and patients to play a role in theAllow for nurses and patients to play a role in the
transformation in healthcare by providing feedbacktransformation in healthcare by providing feedback
to corporations developing EHRs (Weaver,to corporations developing EHRs (Weaver,
Lindsay, & Gitelman, 2012)Lindsay, & Gitelman, 2012)
Some patient portals allow for directSome patient portals allow for direct
communication between patients and nurses tocommunication between patients and nurses to
answer questions and enhance patient teachinganswer questions and enhance patient teaching
(Coyle, 2012)(Coyle, 2012)
In a study, health insurance companies savedIn a study, health insurance companies saved
about $1.7 million over 5 years of EHR useabout $1.7 million over 5 years of EHR use
(Agency for Healthcare Research and Quality,(Agency for Healthcare Research and Quality,
2011)2011)

8. Social MediaSocial Media
Nurses and other healthcare providers can connect with colleaguesNurses and other healthcare providers can connect with colleagues
worldwide with remaining mindful of information shared (Weaver, Lindsay,worldwide with remaining mindful of information shared (Weaver, Lindsay,
& Gitelman, 2012)& Gitelman, 2012)
Facebook pages with private settings can be good source of information orFacebook pages with private settings can be good source of information or
forums for a certain health issue in the community (Weaver, Lindsay, &forums for a certain health issue in the community (Weaver, Lindsay, &
Gitelman, 2012)Gitelman, 2012)
Facebook pages by associations such as The American NursesFacebook pages by associations such as The American Nurses
Association can be a good source of education (Weaver, Lindsay, &Association can be a good source of education (Weaver, Lindsay, &
Gitelman, 2012)Gitelman, 2012)
Twitter has been a source of frequent, topic-specific updates by usingTwitter has been a source of frequent, topic-specific updates by using
hashtags regarding certain health topics or healthcare organizationshashtags regarding certain health topics or healthcare organizations
(Weaver, Lindsay, & Gitelman, 2012). For example “#heartdisease” or(Weaver, Lindsay, & Gitelman, 2012). For example “#heartdisease” or
following the Center for Disease Control.following the Center for Disease Control.
LinkedIn serves as a great place to network and connect with colleaguesLinkedIn serves as a great place to network and connect with colleagues
and potential job opportunities for healthcare providers (Weaver, Lindsay, &and potential job opportunities for healthcare providers (Weaver, Lindsay, &
Gitelman, 2012)Gitelman, 2012)
34% of Internet users read about other people’s health experiences online34% of Internet users read about other people’s health experiences online
(Fox, 2011) and 6% post questions or comments online (Weaver, Lindsay,(Fox, 2011) and 6% post questions or comments online (Weaver, Lindsay,
& Gitelman, 2012)& Gitelman, 2012)
Patients are more likely to use social media than health professionalsPatients are more likely to use social media than health professionals
(Antheunis, Tates, & Nieboer, 2013)(Antheunis, Tates, & Nieboer, 2013)

9. Benefits & Risks of SocialBenefits & Risks of Social
MediaMedia
The use of social media to reach patients is beneficial because it allows healthcare organizationsThe use of social media to reach patients is beneficial because it allows healthcare organizations
and providers to reach a large audience quickly and efficiently (Antheunis, Tates, & Nieboer,and providers to reach a large audience quickly and efficiently (Antheunis, Tates, & Nieboer,
2013)2013)
Patients can communicate directly with each other or their healthcare providers to answer anyPatients can communicate directly with each other or their healthcare providers to answer any
questions or ease anxiety about health issues (Weaver, Lindsay, & Gitelman, 2012)questions or ease anxiety about health issues (Weaver, Lindsay, & Gitelman, 2012)
The use of social media has proven to be a cost-effective way of improving the relationshipThe use of social media has proven to be a cost-effective way of improving the relationship
between provider and patient and enhance communication (Antheunis, Tates, & Nieboer, 2013)between provider and patient and enhance communication (Antheunis, Tates, & Nieboer, 2013)
Privacy concerns are one of the main barriers to patient use of social media (Antheunis, Tates, &Privacy concerns are one of the main barriers to patient use of social media (Antheunis, Tates, &
Nieboer, 2013)Nieboer, 2013)
Healthcare providers are less likely to use because they feel it is insufficient (Antheunis, Tates, &Healthcare providers are less likely to use because they feel it is insufficient (Antheunis, Tates, &
Nieboer, 2013)Nieboer, 2013)
Many consumers are hesitant to research their health conditions for fear of finding unreliableMany consumers are hesitant to research their health conditions for fear of finding unreliable
information (Antheunis, Tates, & Nieboer, 2013)information (Antheunis, Tates, & Nieboer, 2013)

10. Implications of Internet & SocialImplications of Internet & Social
Media on Health ConsumersMedia on Health Consumers
Virtual communities have helped patients findVirtual communities have helped patients find
results by connecting, interacting, and sharingresults by connecting, interacting, and sharing
experiences.experiences.
In remote areas social media through mobileIn remote areas social media through mobile
phones may result more cost-effective andphones may result more cost-effective and
increase access & ease healthcare disparity.increase access & ease healthcare disparity.
Nurses have been able to communicate withNurses have been able to communicate with
colleagues and remain updating with recentcolleagues and remain updating with recent
innovations and developments.innovations and developments.
Nursing education programs use social media toNursing education programs use social media to
connect current and past students and shareconnect current and past students and share
information.information.
(Barry & Hardiker, 2012)(Barry & Hardiker, 2012)

11. Ethical Issues related to InternetEthical Issues related to Internet
and Social Media Useand Social Media Use
Evidence suggests that internet and social mediaEvidence suggests that internet and social media
consumers are hesitant and distrusting of much of theconsumers are hesitant and distrusting of much of the
health information online.health information online.
There is un-moderated distribution of informationThere is un-moderated distribution of information
which can negatively affect gullible consumers.which can negatively affect gullible consumers.
Breaches of privacy on behalf of nurses and otherBreaches of privacy on behalf of nurses and other
providers can seriously affect nurses, patients, andproviders can seriously affect nurses, patients, and
the employer.the employer.
Nurses and healthcare providers must monitor theirNurses and healthcare providers must monitor their
social media content to avoid unprofessional,social media content to avoid unprofessional,
defamatory, illegal, racial, or misogynistic postings.defamatory, illegal, racial, or misogynistic postings.
Employers still need to enforce a balance betweenEmployers still need to enforce a balance between
allowing employees and patients to access socialallowing employees and patients to access social
media and also protecting confidentiality, security, andmedia and also protecting confidentiality, security, and
employer’s legal interests.employer’s legal interests.
(Barry & Hardiker, 2012)(Barry & Hardiker, 2012)

12. The Role of the INS in use ofThe Role of the INS in use of
Internet & Social MediaInternet & Social Media
The INS must be aware of where and how patients are seekingThe INS must be aware of where and how patients are seeking
health information and ensure clinicians are using effective methodshealth information and ensure clinicians are using effective methods
to disseminate health information.to disseminate health information.
Understanding the process of e-patient information-seekingUnderstanding the process of e-patient information-seeking
behavior, knowledge generation, and decision making will guidebehavior, knowledge generation, and decision making will guide
nurses in effective education and support in patient medical decisionnurses in effective education and support in patient medical decision
making.making.
Collaborating with other clinicians to plan strategies for data andCollaborating with other clinicians to plan strategies for data and
information processing to improve patient care.information processing to improve patient care.
The INS should look for opportunities to leverage the resources,The INS should look for opportunities to leverage the resources,
ideas, and insights they offer to solve health care problems and spurideas, and insights they offer to solve health care problems and spur
innovation.innovation.
Should work with clinicians and IT personnel to enhance theShould work with clinicians and IT personnel to enhance the
development of software for storage and retrieval of information anddevelopment of software for storage and retrieval of information and
enhance provider-patient communication.enhance provider-patient communication.
(Gee et. al., 2012)(Gee et. al., 2012)

13. ReferencesReferences
Agency for Healthcare Research and Quality [AHRQ]. (2011). Electronic alerts, patient education, and performance reports improve adherence to guidelines designed to reduce early
elective inductions. Retrieved from www.innovations.ahrq.gov/content.aspx?id=3161.
Antheunis,M. Tates,K., Nieboer,T. (2013). Patients' and health professionals' use of social media in healthcare: Motives, barriers and expectations . Original Research article. Patient
Education and Counseling, 92(3), 426.
Barry, J. & Hardiker, N. (2012). Advancing nursing practice through social media: A global perspective. Online Journal of Nursing . 17. Online Journal of Nursing, 17, DOI:
10.3912/OJIN.Vol17No03Man05
Blumenthal, D. (2009) The federal role in promoting health information technology. The Commonwealth Fund, 2, Retrieved from
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CDC (2011). Social media tool kit.
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Cohen, R A, Stussman B. (2010). Health information technology use among men and women aged 18-64: Early release of estimates from the national health interview survey, January–
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Coyle, S. (2012). Conquering the fear of technology. Advance for Nurses. Retrieved from http://nursing.advanceweb.com/Features/Articles/Conquering-the-Fear-of-Technology.aspx.
Fox, S. (2011). The social life of health information, 2011. In Pew Internet & American Life Project. Retrieved from http://pewinternet.org/Reports/2011/Social-Life-of-Health-Info.aspx.
Gee, P. M., Greenwood, D. A., Kim, K. K., Perez, S. L., Staggers, N., & DeVon, H. A. (2012). Exploration of the e-patient phenomenon in nursing informatics. Nursing Outlook. 60. e9-e16.
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