Looking to influence behavior through social media
Healthcare is no different than any other industry—it’s starting to recognize the power and importance of social media.
A recent survey from PwC revealed that the majority of consumers are increasingly looking to online communities as a way to seek medical information, track and share symptoms, and broadcast how they feel about a provider, physician, drug, or health plan. Fifty-four percent of the respondents in the PwC survey said they feel “very comfortable” going to online physician communities for advice related to their health situation.
With the potential to engage patients through social media mounting, it’s no wonder why West County Health Centers, a Guerneville, Calif.-based not-for-profit community health center, recently decided to take a chance and invest in WellFx’s (Petaluma, Calif.) social media platform, which it will deploy on Sept. 23. While the platform is relatively untested in the marketplace (WellFx is a newcomer to the industry), West County is banking on it to allow patients to talk about their illnesses with each other, and ultimately change their behavior. The organization preferred to keep the social media platform in house, rather than referring patients to a third-party social networking site that could have a negative impact on HIPAA-related privacy.
In a recent interview with HCI’s Associate Editor Gabriel Perna, Jason Cunningham, D.O., medical director at the Guerneville, Calif.-based West County Health Centers, explained why the organization thinks this platform can be a major driver for changing behavior. Below are excerpts from that interview.
Just like everyone else in primary care, we recognize the current model of care does not incentivize improvement around chronic illness or self management of health. We have short visits and episodic care. As everyone else is starting to figure out, there’s this big train coming down the pipeline; costs are out of control and the value of care is not very good in the health system in general.
We recognized that the Holy Grail around changing chronic illness and changing cost, particularly in primary care, is changing behavior. At West County, we strategically decided to change our delivery model to optimize our ability to affect behavior. We realized that the long-term trusting relationship— being able to engage patients, being able to have active listening, getting our providers to have understanding of motivational interviewing, and some of these other techniques— are all part of the skill set that we need to invest in.
We started doing group visits around a lot of chronic illnesses, and we saw how influencing behavior change by increasing education coupled with patients engaging each others, can be really impressive. We recognize the group visit model, with patients engaging with each other, influences behavior. After the group visits ended, a lot of our patients really wanted to [continue to] engage with each other. Those patients could say things with more influence often than the healthcare provider. So there came WellFx. We think patients engaging with each other online, after their visits, has significant potential.
Why is patient engagement so important to a better outcome?
I think we’re recognizing that in healthcare, we have less influence over health outcomes than we want to believe. The reality is, patients’ behavior—what they do, how much they exercise, and what they eat—is much more influenced by who they are surrounded by and their environment than access to their provider for 15-20 minutes. I think if we’re going to be participants in improved health for our nation, we have to tap into the patient’s ability to engage around their own illness, and engage with things that influence their ability to manage their disease.
How do all these regulatory mandates from the government help boost your initiative?
The focus on the cost of our health system, and the runaway costs, primarily focused on chronic illness, has allowed us to think outside our normal structure. And through incentives, the health system is starting to encourage the ability for us as a provider to change how chronic illness is treated. We are participating in pay for performance and quality incentives, we’re forming our own care organization, and we recognize that if we can incentivize the chronic illness around behavior, we’ll see a significant reduction in costs. We’ve already begun to see it.
How do you foresee this platform working?
It’s just like you would think a social networking platform [would look] in that you can create a profile. It’s different in that you can secure every aspect of that profile and let certain people view your name, and others view an acronym. In order to participate in that space, the patient will have to be one of our active patients. We are participating with a number of other health centers to make it bigger.
And then, what we’re doing to start with, we’ll have it be an extension of our existing groups. So a patient who has just completed a diabetes management class will be engaged both in the group and by using that platform to extend the group afterwards. We’re starting with diabetes. We have an addiction group that we’ll use it for. Chronic pain, childhood obesity, and then we have an alternative medicine group that we’re going to use for it.
It sounds like you’re going to keep this platform fairly exclusive, limited to your patients, at first?
In concept, it’s a product that we are investing in, and we have allowed into that world patients who are active members of ours. We’re doing it with it a number of our sister clinics because there has to be enough volume to make this work. It’s not exclusive; it’s an extension of our own relationship, of our own product, rather than just a free world. If you think about that from a healthcare strategic perspective, that may be a part of what enhances our platform offer for other patients.
You mentioned security was one of your chief concerns with implementing a social media platform, what are any others you’ve had?
Our ability to have enough of a base of patients to engage with each other was an initial concern. We were also concerned about patients saying things online that we may be responsible for. If they had a dialogue online that had clinical implications, we wanted to set up the platform that we were not driving them to get advice from us on that platform. Part of the reason we went in with multiple health centers was to make it bigger than us, for that patient expectation.
How will you mark progress on this initiative? Where do you see it going in the next few years?
We have a number of tools that we use to monitor the patients’ self-management, and their feelings about their health. There is a tool that monitors their perception of their health, and one called a patient activation measure, which measures their ability to self-manage. We’re going to measure those outcomes for patients participating in these groups, online or not. We’re also measuring their clinical outcomes around specific chronic illnesses. We’re also measuring their satisfaction of the product, and their perception of how it changes their behavior around chronic illness.