Attitudes on the use of Social Media in Healthcare Communications

Filed in Research, Social Media by on April 24, 2013 1 Comment

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Published in the Journal of Communication in Healthcare 2013 Vol. 6 No. 1

Abstract

CIH_shadow_RGBSocial media has become a mainstay of communication between business-to-business and business-to-consumer endeavors. However, lacking is a fair and balanced discussion of the risks and benefits of utilization and implementation, in particular, within healthcare communications.

Our research objective is to assess current attitudes of healthcare, pharmaceutical and life sciences executives on the topic.

We conducted an online survey with 107 people from varying positions and perspectives within these industries. From CEO to CIO, from Marketing Director to Brand Manager, respondents are active in their positions, serve primarily the United States, and provide diversity to our sample.

  • When asked about whether or not marketers should be permitted to use social media to promote their products and services to the public, most were positive.
  • Very few believe the Food and Drug Administration is doing an adequate monitoring job or has the resources it needs.
  • About half agree with the practice of monitoring social media sites to understand patient needs, concerns and perceptions.
  • Very few believe social media marketing has been transparent and responsible.
  • When assessing social media sites, YouTube ranks as most acceptable.
  • It appears companies wanting to utilize these platforms should be prepared to manage the complexities of this channel.

Background

This research project is a follow-up to the Popovic and Smith 2010 publication in the Journal of Communication in Healthcare (Vol. 3, No. 2) “Tweeting @DoctorWelby: Practical Examples of Social Media in Healthcare.” To assist in the design and statistical analysis of these results, the authors partnered with Stephen Hellebusch of Hellebusch Research and Consulting, Inc., and Gary Mullet of Gary Mullet and Associates.

Popovic and Smith continue to believe that social media should be embraced as an integral part of any healthcare communication plan, and see signs that this is occurring with greater scale and frequency (1). There is a significant amount of debate over the use of social media in healthcare communication from manufacturers, consumers and regulatory bodies. In addition to the obvious regulatory hurdles, the authors question the attitudinal constraints of the channel by communications professionals for this target audience.

Evolving Environment for Social Media in Healthcare

There is no question that the FDA’s lack of leadership in providing guidelines has limited the broad adoption of social media (2). Despite guidelines and requirements for all other channels of communication already in play, social media remains unequally addressed. Some organizations are on hold until the channel is clarified, and others are proceeding with what they already know to be acceptable with other channels. Can these media with arguably disproportionate reach and impact be abused as a promotional communication channel by not being fair and balanced? Absolutely.

While the agency has been anxious to demonstrate a “get tough” stance for the general public, it has not been helpful to companies trying to communicate honestly and with good intent. Knowledgeable consumers and healthcare professionals make more educated decisions when able to access credible information. Internet search is a mainstay, delivering an abundance of information of varying accuracy. Social media influences both search and how content is perceived. The social network member is an uncontrollable action, but the companies who serve them are. Perhaps the question of regulatory leadership or the public health proposition for the wider use of social media in healthcare communications needs to be re-framed.

From the authors’ point of view, only the risk is being examined. The potential benefits and opportunities deserve equal exploration. What seems to be lacking is a fair and balanced discussion of how the general public can benefit from the responsible use of these media (4). An obvious opportunity to improve access to educational information is being missed, particularly for adults in the demographic of 50-64 years of age (5). Does the professional healthcare community have a belief system concerning appropriate uses? Are some social media more effective than others? Does the type of content make a difference? Examining current attitudes and perceptions within this group may add some objectivity to the picture.

Objectives

The objectives of this study are to assess current attitudes and perceptions of healthcare, pharmaceutical and life sciences professionals from various perspectives on the opportunities for appropriate use of social media by organizations by generating feedback from them on current and potential responsible uses. Specifically, to examine perceptions of:

  • Channel Appropriateness
  • Disclosure and Fair Balance
  • Social Media Monitoring

Research Design

Sample

The sample for this research is comprised of 107 professionals working in the healthcare, pharmaceutical and life sciences, with the majority (94%) working in the healthcare and life science markets.

Method

This was an online survey. The questionnaire was designed collaboratively by MarketSMITH Services, Ideahaus® and Hellebusch Research and Consulting, Inc. All interviewing was completed between February 19 and April 11, 2011.

Research Results and Discussion

Agree/Disagree Statements

For each of 22 statements, respondents were asked to indicate if they:

  1. Strongly Agree
  2. Agree
  3. Neither
  4. Disagree
  5. Strongly Disagree
  6. or, No Opinion

All figures show the results in “top two box” scores. Top two box (T2B) represents the percent who said that they “Strongly Agree” or “Agree” with the statement.

Top Two Box Agreement Scores for Social Media Statements

Note: Statements have been abbreviated to create the graph, but are shown in full in the Appendix of this article.

attitudes-graph-1

N=107,Percentage is equal to percentage of total responders.

When asked about whether marketers should be permitted greater use of social media to promote products and services to the public, the data suggests the response was positive although the reason is not entirely clear. One could speculate that fear of crossing an unseen and unknowable boundary, thus facing FDA reprisals, is holding many back from developing communications that could be helpful to physicians and patients.

When assessing channel appropriateness (Figure 1), video sharing YouTube ranks as the most acceptable (68%). Social networks LinkedIn (62%) and Facebook (60%) follow, with less than half of the sample agreeing that micro-blogging Twitter (42%) and photo sharing Flickr (30%) are acceptable. Apparently, media and context is another important consideration calling for additional research. For example, video (a series of pictures and sound) is more favored while single images without sound are not. A more descriptive and invading media has been selected over other media. Additionally, a common characteristic of YouTube is that of a broadcaster’s network while Twitter is regarded as conversational. It may indicate levels of comfort with sharing information but not with engaging in dialogue.

attitudes-graph-2Interestingly, about half (49%) understand that these sites and services are managed by industry sponsors, and there is an expressed concern with their practices (Figure 2). Caveat emptor seems to be a dynamic in play. Half of the consumers believe that companies are misusing social media, and the other half seem accepting of the channel. Given prior work on the subject, Smith and Popovic were surprised by this rating due to some of the negative press that healthcare organizations have received for their strategies.

Not surprisingly, very few (8%) of the professionals surveyed believe the FDA is doing an adequate job in managing the use of social media and (8%) believe that it does not have the resources it needs to improve. Conversely, that data suggests a solid agreement that companies should be permitted to promote to professionals and provide information to the public via social media.

attitudes-graph-3Transparency and trust have always been important foundational concepts when designing strategy and content for social media. Unfortunately, the general perception is that companies to date have not been fully transparent in their use of the channel. Approximately only 4 of 10 believe products and services are promoted responsibly. Nearly one third believe marketers manipulate blogs, chat rooms and discussions. Only 20% trust the information provided on manufacturer web sites. What seems to be an underlying sentiment (Figure 3) is that there has been a history of poor disclosure, that blogs can be and are easily manipulated, chat rooms can be and are filled with “spokesmen,” and discussion boards are slanted to favor the site sponsor. Implementing blog or chat rooms to support educational efforts will remain challenging because of previous experiences, which adds to the current challenge of creating them now. Companies with the desire to utilize these communication platforms will need to learn from history, be diligent in managing the social media channel – being actively involved in the listening and response – to overcome the existing negative perceptions to ever be viewed as a credible source.

Factor Analysis of Data Set

The statistical method used to analyze the survey results was factor analysis. This methodology reveals the underlying dimensions upon which the survey responses were examined. So, if a number of statements relate to one underlying dimension, they are grouped together. If a single statement does not relate to any of the underlying dimensions, it will stand alone.

There are a group of 22 agree-disagree statements that yielded six underlying factors represented by several statements plus two others that were each represented by a single statement:

“I access my favorite social media site at least once a day, and on most days, more frequently than that.”

The first of these is the only statement referring to personal use of social media.

The other factors are labeled based on content. The groupings indicate that the same people treated the various statements similarly, judging agreement in similar ways. The labels reflect the overarching issues involved.

The choices were not mutually exclusive, meaning each was a singular choice of acceptability.

Dimension 1. Which Social Media Are Acceptable.

  • YouTube is acceptable for use in healthcare communication.
  • Facebook is acceptable for use in healthcare communication.
  • Flickr is acceptable for use in healthcare communication.
  • LinkedIn is acceptable for use in healthcare communication.
  • Twitter is acceptable for use in healthcare communication.
  • Text Messaging is acceptable for use in healthcare communication.

Dimension 2. Which Social Media Activities Should Be Utilized.

  • Pharmaceutical and healthcare marketers should be permitted to use social media communication strategies to promote their products and services to the allied healthcare professional community.
  • Pharmaceutical and healthcare marketers should be permitted to use social media to provide information to the general public.
  • Pharmaceutical and healthcare marketers should be permitted to make greater use of social media channels to promote their products and services to the general public.
  • Companies that monitor social media sites to gain a better understanding of the market’s needs are not misusing this information.

Dimension 3. About The FDA And Its Role.

  • The FDA has all of the resources and expertise to effectively regulate how pharmaceutical and healthcare companies use social media.
  • The FDA should be solely responsible for defining how pharmaceutical and healthcare marketers are permitted to use social media.
  • The FDA has done a very good job regulating how pharmaceutical and healthcare marketers use social media to promote their products and services.

Dimension 4. About Pharmaceutical Marketers And Their Role.

  • Pharmaceutical and healthcare marketers have been very responsible in their use of the internet to promote their products and services.
  • Social media is a very effective sales channel for the company that I work for.
  • Pharmaceutical and healthcare marketers are very responsible and 100% transparent with disclosing potential conflicts of interest.
  • To date, pharmaceutical and healthcare marketers have been conservative in how they use social media.
  • Companies that monitor social media sites to gain a better understanding of the market’s needs are not misusing this information.

Dimension 5. Pharmaceutical Marketers and Trust.

  • Pharmaceutical and healthcare marketers establish unbranded websites to steer consumers towards their own branded product to treat that disease.
  • Pharmaceutical and healthcare marketers manipulate blogs, chat rooms and discussion boards to put their products in a better light.
  • I absolutely trust the information that I can access on a manufacturer’s website to be fair and balanced (e.g. to not favor that company’s product or service).

Classification

Respondents were asked a series of classification questions to assist in our statistical analysis:

  • The highest percentages of respondents are from the Northeastern (40%) or Western (23%) United States Census Regions. A small percentage (4%) is from outside the United States.
Geography    
USA Total

95

88.8%

US Region    
 NorthEast

43

40.2%

 South

15

14.0%

 MidWest

12

11.2%

 West

25

23.4%

Foreign

4

3.7%

Refused

8

7.5%

Total

107

100.0%

  • The highest percentage (41%) is in the 35-54 year-old age group, with the balance of the sample split between 25-34 (22%) and 55+ (30%).
Respondent Age  
18-24

6

5.6%

25-34

24

22.4%

35-54

44

41.1%

55+

32

29.9%

Refused

1

0.9%

Total

107

100.0%

  • Just over half (53%) are male.
What is your gender?  
Female

36

33.6%

Male

57

53.3%

Refused

14

13.1%

Total

107

100.0%

  • Respondents come from different areas of healthcare communications, providing a broad outlook from multiple perspectives. Many indicated Healthcare Services (21%) or Pharmaceuticals (26%) as their industry of employment, two of the prelisted selections.
What area of pharmaceutical business-healthcare do you work in?
Biologics

4

3.7%

Heathc.s

22

20.6%

Pharma

28

26.2%

Med dev

4

3.7%

Man care

3

2.8%

Other

40

37.4%

Ref.

6

5.6%

Total

107

100.0%

  • The largest group (37%) picked “Other” and were asked to specify. Responses included “Marketing” or “Marketing Research,” and a notable few identified themselves as “Communication / Ad Agency,” “Education” or “Consultant.”
  • When asked about their role, the highest percent (31%) indicated “Marketing,” “Sales” (13%) and “Marketing Research/Information” (11%).
Which of these best describes your role in your organization?
Marketing

33

30.8%

Sales

14

13.1%

New P.D.

5

4.7%

MR/Info

12

11.2%

Drug Reg.L

5

4.7%

R&D

7

6.5%

Finance

2

1.9%

Other

26

24.3%

NA/Ref

2

1.9%

HR

1

0.9%

Total

107

100.0%

  • About a fourth (24%) replied “Other,” and, again, variation was evident, with responses including “Management,” “Education,” “Design,” “Public Relations,” “Owner,” and “Business Development.”
  • With respect to the respondent’s title, a sizable percent (22%) are “Chief Operating Officer” or “Chief Executive Officer,”with Directors (16%) and finally Managers (22%).
What is your job title?
     
Director

17

15.9%

C-level

24

22.4%

NA

2

1.9%

Other

26

24.3%

VP

14

13.1%

Gen.GpMan

2

1.9%

Man

21

19.6%

Clinicalr&d

1

0.9%

Total

107

100.0%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

  • Those checking “Other” (24%) were Founders, President, Nurses, Consultants, or Analysts.
  • The respondent firms represent a range from the small (16% under $5MM) to very large (14% greater than $1B). Four in ten did not respond.
Roughly, what level of retail sales did your company achieve in its last
       
<$5MM

17

15.9%

 
$5-50MM

14

13.1%

$50-100MM

10

9.3%

$100MM-1B

8

7.5%

>$1B

15

14.0%

NA/Ref

43

40.2%

 
Total

107

100.0%

 

 

Conclusions

Half of the sample companies are not participating in any social media – for varying reasons. Those sample companies who are participating, in different sites and services, are questioned and not fully trusted, and perhaps justifiably so.

There is clear evidence that the lack of regulatory guidance has hindered the adoption of social media by healthcare communication professionals. It is not an effective long-term strategy that benefits the general public.

It’s important to remember that this survey was a follow up to a previous article. Within that article is the basic premise that social media, given its prevalence in the general public, should be an integral part of any communications plan. It is the authors’ opinion that the lack of regulatory guidance has hindered, but not entirely restricted, the adoption of social media in healthcare communication. While federal regulators may be doing their due diligence, the absence of guidance to industry shortchanges the general public. We acknowledge the complexity of the undertaking. However, it seems there should be more effort and resources applied to this shortcoming that will benefit patient education.

The Food and Drug Act was established in 1906 and gave the FDA power to regulate the communication process to ensure that “advertising claims” are appropriate and contain a “fair balance” of the service or product’s benefits as well as the risks associated with its use. This job has required the agency to adapt to changes in the market, procedures and technology. Direct to consumer advertising had its challenges and dissenters, but it is a salient example. It is inconceivable to the authors the agency in charge of “drug safety” seems slow to respond to this channel, as it already does with so many others, and fulfill its mandated responsibility to protect the American consumer.

In fairness, it is our belief that professionals in healthcare communication have done an admirable job in regulating the use of this new channel, for the most part. Because of social media technologies, consumers are clearly much more knowledgeable and informed about the temptations of unscrupulous marketers than was possible when the law was enacted. “Caveat emptor” has always been a useful philosophy and never more applicable than it is today.

Healthcare professionals or consumers judge the validity of anything they read, see or hear with healthy doses of skepticism (5). This market reality helps to explain the restraint of communication professionals but does not absolve the agency of its responsibility. Social media or “Web 2.0” strategy and tactics are here to stay. Ignoring the problem will not make the problem go away. It is time the FDA developed a viable plan, to demonstrate at least a modicum of leadership on an issue that touches the life of nearly every consumer in the United States.

This study only begins to address the attitudes on social media in healthcare, as well as the reasons behind the stated preferences and beliefs. Although content, sources and information are primary concerns, how much does the media type, audience, and context under which it is presented impact responses? We as authors, and as professionals within this space, believe additional research and discussions are required to address our further understanding. Although some of the data is counter-intuitive to our experience and opinions, the data is the data.

More research is required, as well as conversations about the results of the research. This is where the FDA could begin its due diligence and leadership, and where trade organizations could leverage its access to professional and corporate members. Together, as an industry, we could very quickly identify and develop a cohesive plan for moving forward to serve business, as well as consumer needs.

 

Appendix

Appendix Table 1. Statements Rated by Respondents

  • a. Pharmaceutical and healthcare marketers should be permitted to use social media to provide information to the general public.
  • b. Pharmaceutical and healthcare marketers should be permitted to use social media communication strategies to promote their products and services to the allied healthcare professional community.
  • c. Pharmaceutical and healthcare marketers should be permitted to make greater use of social media channels to promote their products and services to the general public.
  • d. Pharmaceutical and healthcare marketers have been very responsible in their use of the internet to promote their products and services.
  • e. The FDA should be solely responsible for defining how pharmaceutical and healthcare marketers are permitted to use social media.
  • f. The FDA has done a very good job regulating how pharmaceutical and healthcare marketers use social media to promote their products and services.
  • g. The FDA has all of the resources and expertise to effectively regulate how pharmaceutical and healthcare companies use social media.
  • h. I access my favorite social media site at least once a day, and on most days, more frequently than that.
  • i. To date, pharmaceutical and healthcare marketers have been conservative in how they use social media.
  • j. Pharmaceutical and healthcare marketers establish unbranded websites to steer consumers towards their own branded product to treat that disease.
  • k. Pharmaceutical and healthcare marketers manipulate blogs, chat rooms and discussion boards to put their products in a better light.
  • l. Pharmaceutical and healthcare marketers are very responsible and 100% transparent with disclosing potential conflicts of interest.
  • m. The promotion of dietary supplements (e.g. vitamins, health/wellness) should be regulated by the FDA, just like they do for over the counter medicines.
  • n. I absolutely trust the information that I can access on a manufacturer’s website to be fair and balanced (e.g. to not favor that company’s product or service).
  • o. Social media is a very effective sales channel for the company that I work for.
  • p. Twitter is acceptable for use in healthcare communication.
  • q. Facebook is acceptable for use in healthcare communication.
  • r. YouTube is acceptable for use in healthcare communication.
  • s. LinkedIn is acceptable for use in healthcare communication.
  • t. Flickr is acceptable for use in healthcare communication.
  • u. Text Messaging is acceptable for use in healthcare communication.
  • v. Companies that monitor social media sites to gain a better understanding of the market’s needs are not misusing this information.
  • 1.  Popovic, K., Smith, D.C. (2010) “Tweeting@doctorwelby: Practical examples of social media in healthcare” Journal of Communication in Healthcare Volume 3, Number 2
  • 2.  Greene, MD, PhD, J.A (2010) “Pharmaceutical Marketing and the New Social Media”, New England Journal of Medicine
  • 3.  Hisey, R.T, (2010) “To friend or not? New insights about social networks in the life sciences industry” Deloitte Research Study
  • 4.  Madden, M. (2010) “Older adults and Social Media: “Social networking use among those ages 50 and older nearly doubled over the past year” Pew Research Center
  • 5.  Nielsen (2009) “Global Advertising: Consumers Trust Real Friends and Virtual Strangers the Most” Nielsen Research Study

Author information

  • Kevin Popovic is the Founder & CEO of Ideahaus®, and the author of Satellite Marketing™
  • Chauncey Smith is a Senior Director of Client Engagement for Klick Health, and owner of MarketSMITH Services, LLC, McKees Rocks, PA, USA.
  • Steven Hellebusch is the President of Hellebusch Research & Consulting, Inc., Cincinnati, OH, USA.

[/ismember]

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Published in the Journal of Communication in Healthcare 2013 Vol. 6 No. 1

Abstract

CIH_shadow_RGBSocial media has become a mainstay of communication between business-to-business and business-to-consumer endeavors. However, lacking is a fair and balanced discussion of the risks and benefits of utilization and implementation, in particular, within healthcare communications.

Our research objective is to assess current attitudes of healthcare, pharmaceutical and life sciences executives on the topic.

We conducted an online survey with 107 people from varying positions and perspectives within these industries. From CEO to CIO, from Marketing Director to Brand Manager, respondents are active in their positions, serve primarily the United States, and provide diversity to our sample.

  • When asked about whether or not marketers should be permitted to use social media to promote their products and services to the public, most were positive.
  • Very few believe the Food and Drug Administration is doing an adequate monitoring job or has the resources it needs.
  • About half agree with the practice of monitoring social media sites to understand patient needs, concerns and perceptions.
  • Very few believe social media marketing has been transparent and responsible.
  • When assessing social media sites, YouTube ranks as most acceptable.
  • It appears companies wanting to utilize these platforms should be prepared to manage the complexities of this channel.

Background

This research project is a follow-up to the Popovic and Smith 2010 publication in the Journal of Communication in Healthcare (Vol. 3, No. 2) “Tweeting @DoctorWelby: Practical Examples of Social Media in Healthcare.” To assist in the design and statistical analysis of these results, the authors partnered with Stephen Hellebusch of Hellebusch Research and Consulting, Inc., and Gary Mullet of Gary Mullet and Associates.

Popovic and Smith continue to believe that social media should be embraced as an integral part of any healthcare communication plan, and see signs that this is occurring with greater scale and frequency (1). There is a significant amount of debate over the use of social media in healthcare communication from manufacturers, consumers and regulatory bodies. In addition to the obvious regulatory hurdles, the authors question the attitudinal constraints of the channel by communications professionals for this target audience.

Evolving Environment for Social Media in Healthcare

There is no question that the FDA’s lack of leadership in providing guidelines has limited the broad adoption of social media (2). Despite guidelines and requirements for all other channels of communication already in play, social media remains unequally addressed. Some organizations are on hold until the channel is clarified, and others are proceeding with what they already know to be acceptable with other channels. Can these media with arguably disproportionate reach and impact be abused as a promotional communication channel by not being fair and balanced? Absolutely.

While the agency has been anxious to demonstrate a “get tough” stance for the general public, it has not been helpful to companies trying to communicate honestly and with good intent. Knowledgeable consumers and healthcare professionals make more educated decisions when able to access credible information. Internet search is a mainstay, delivering an abundance of information of varying accuracy. Social media influences both search and how content is perceived. The social network member is an uncontrollable action, but the companies who serve them are. Perhaps the question of regulatory leadership or the public health proposition for the wider use of social media in healthcare communications needs to be re-framed.

From the authors’ point of view, only the risk is being examined. The potential benefits and opportunities deserve equal exploration. What seems to be lacking is a fair and balanced discussion of how the general public can benefit from the responsible use of these media (4). An obvious opportunity to improve access to educational information is being missed, particularly for adults in the demographic of 50-64 years of age (5). Does the professional healthcare community have a belief system concerning appropriate uses? Are some social media more effective than others? Does the type of content make a difference? Examining current attitudes and perceptions within this group may add some objectivity to the picture.

Objectives

The objectives of this study are to assess current attitudes and perceptions of healthcare, pharmaceutical and life sciences professionals from various perspectives on the opportunities for appropriate use of social media by organizations by generating feedback from them on current and potential responsible uses. Specifically, to examine perceptions of:

  • Channel Appropriateness
  • Disclosure and Fair Balance
  • Social Media Monitoring

The remainder of this article is available to members of the Ideahaus Professional Community. Sign up for the free Social Member level here.

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About the Author ()

Kevin Popović is a communications expert, featured speaker, and author of '20YEARS Communications: 20 Leaders, 20 Questions, 100's of Lessons.' After more than 30 years of professional experience, he helps business leaders make smart decisions about communications. In 2010, "KP" was ranked #43 in Fast Company's The Influence Project measuring the "most influential people online." In 2014 he was ranked as one of the "Top 40 Digital Strategists in Marketing" by the Online Marketing Institute.

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