Mitigating Hope and Hype: The Evolving Role of the Physician in the Era of eHealth

Routine searches of Twitter for health information can help physicians stay abreast with the types of conversations their patients are having outside the exam room, according to researchers from the University of British Columbia (UBC).

The study (currently under review), presented recently at the 2015 annual meeting of the American Association for the Advancement of Science (AAAS), finds that contrary to the popular opinion that physicians are somewhat reluctant to use social media, healthcare professionals are, in fact, using Twitter to share health information.

Twitter: It’s About More than Just What Your Teenager Had for Lunch

nuviun had the pleasure of speaking with the study’s lead author, Dr. Julie Robillard, professor of neurology at UBC’s National Core for Neuroethics and Djavad Mowafaghian Centre for Brain Health. Robillard discussed her interest in health conversations on Twitter:

Very little research was looking at Twitter and health at the time [2013]. I had this idea to discuss aging on Twitter… but when I presented it, people thought that Twitter was just a site where a bunch of teenagers talk about their lunches. 

According to Robillard, about 80% of Internet users seek health information online. As social media becomes increasingly popular, academic research is looking to define this landscape, and to better understand the health information seeking behavior that takes place there.

"Many people go online for health information, but little research has been done on who is participating in these discussions or what is being shared," says Robillard.

When no tools that met her needs for this research could be identified, Robillard worked with a British Columbia Institute of Technology engineering faculty member, Dr. Craig Hennessey, to create her own. In order to determine who was searching for information, what information was being shared, and identify themes, Robillard’s team spent six months studying tweets about stem cells through data mining and content analysis. Specifically, she looked at two cohorts of stem cell-related tweets: spinal cord injuries and Parkinson’s disease. Robillard told nuviun:

“Stem cells interested us because we thought there might be a controversial impact… We were hoping to capture the controversy, but we found very little… perhaps because [the conversations] were focused on specific medical conditions in our sample.”

Her study found that most tweets about stem cells during the 6-month period concerned research findings, particularly those that were perceived by the public as medical breakthroughs. Links to research reports were the most commonly shared content.

Robillard also found differences in the types of information shared by users tweeting about spinal cord injury and Parkinson’s disease. Tweets concerning spinal cord injury discussed clinical trials, while tweets about Parkinson’s disease were mostly about new tools or research methods.

Patient 2.0

These research findings suggest a shift in the patient-physician relationship. Years ago, physicians were the main source of health information for lay people. Physicians were trusted to stay on top of the latest medical research, to vet it, and apply its findings when appropriate. In the information age, however, those research papers (or at least news articles about them) are easily accessible online.

According to Pew Research Center, 72% of Internet users say they searched for health information online in the last year. This means that many people have searched for their symptoms online, and may have a sense of what their course of treatment might look like before they even enter the exam room.

More informed – and sometimes misguided – patients arrive at clinics with suggestions about possible alternative treatments they found online. At least one aspect of the physician’s role then becomes discussing how a patient’s Internet research may or may not relate to their case specifically. Or that perhaps the study was done on animal models and is not yet in human trials. To make the best use of their time with patients, physicians need to at least be aware that these health conversations are taking place online.

Doctor 2.0

Physicians are typically understood as late adopters of technology. Robillard’s Twitter study found that physicians and healthcare professionals represented a portion of users that were tweeting about stem cells. While Robillard was happy to see that some doctors are on Twitter and involved in these health-related discussions, she believes that all physicians need to at least know that health conversations occur in social media.

A simple search on Twitter using a few disease-related keywords could mean that physicians are not only aware of the most recent research on a certain disease, but they have a sense of the tone of the tweets, and any spin created by well-meaning journalists.

Armed with this information, physicians are better able to anticipate the sorts of questions patients may have. In introductory comments at Robillard’s AAAS presentation, Dr. Judy Illes, professor of neurology and Canada Research Chair in neuroethics at UBC, stated that the role of physicians in the information age might be “mitigating hope and hype” or creating “informed hope.”

Social media may help physicians become more aware of the types of health conversations their patients have online, and the types of scientific research patients may encounter. This may help doctors to temper the expectations of their patients about potential treatments.

The nuviun industry network is intended to contribute to discussion and stimulate debate on important issues in global digital health. The views are solely those of the author.