One of the most compelling images from the Olympic opening ceremony was the tribute to the NHS, unifying a Britain that is increasingly a digital nation. This digital future lies at the heart of the NHS Information Strategy, which seeks to transform our experience of care by using feedback from patients, users and communities to improve services.
With 77% of British households connected to the internet and 59% regularly using social networks, online feedback will become increasingly important. Yet, our experience at Dell reveals a range of responses by care organisations to this cultural change. At one end of the spectrum we see some organisations that are reluctant to engage, perhaps through fear of loss of control, potential misuse, network security concerns, or confidentiality issues.
We see others experimenting with social media, for example, through: blogs, Twitter, Facebook and YouTube; guiding people to high-quality, evidence-based information like NHS Choices; encouraging patient support networks; involving communities in co-producing services; and sharing professional expertise. Examples include MHChat (mental health), SWSCmedia (social work and care), WeNurses (nursing), OTalk (occupational therapy) and #nhssm, a community for care professionals and those, from the public or private sector, interested in healthcare and social media, to share ideas and expertise on topics such the use of social media during epidemics.
In response to exponential growth in social media use during crises, the American Red Cross recently worked with Dell to launch its Digital Operations Centre, which uses innovative social media aggregation and analysis tools, supported by training for staff and volunteers, to identify trends, anticipate and respond to public needs and connect people with resources during emergencies.
Changing attitudes to social media are perhaps best illustrated by Patient Opinion, a non-profit organisation which allows patients to provide feedback on their experiences of care and health service staff to respond. Resulting service improvements are reported, moving closer to the full integration of social media into care.
However, these initiatives have raised issues which may prevent the effective use of social media in delivering the Strategy’s aims.
As detailed information on patients and users is collected, safeguards to ensure security, privacy, appropriate ownership, access and control assume greater significance. This is evidenced by the Caldicott review on confidentiality, the Department of Health’s guidance on information governance and the requirement to adopt common standards.
Social media have changed the ways our lives are accessible to others. For care professionals, blurring boundaries between public, private and professional raises potential risks in maintaining confidentiality, ethical boundaries and public trust; encouraging online feedback may also place the public in a vulnerable position.
The codes of conduct expected of care professionals are equally applicable online, however new circumstances also arise. The General Medical Council, the British Medical Association and the Nursing and Midwifery Council have issued guidance on the appropriate use of social media to help address this.
Care organisations also remain mindful of a digital divide, where 5.7 million British households are without an internet connection. These people tend to be older, with low incomes, disabilities or long-term conditions and may have a high requirement for care.
Face-to-face and online feedback will need to be captured, combined and analysed to deliver the Strategy’s aims. This will be complex: the NHS provides 1 million interactions every 36 hours and journeys of care can cross a range of services from multiple organisations.
To overcome these challenges, at a time when the NHS has to find efficiency savings of £15-£20 billion, will require care organisations to implement strategies which clearly demonstrate how investment in patient feedback and social media delivers service improvement.
Andrew Jackson, healthcare IT consultant and social media professional at Dell.