At the beginning of this month Facebook celebrated its first 10 years in existence – today it has 1.23 billion users. 10 years ago they did not exist, now they have as many users as there are people in India. This fact clearly outlines the disruptive innovation of the internet; and Facebook has to be ranked alongside Google and Wikipedia as the stand out examples of the radical changes we’ve witnessed in our interactions with the web in the past 10 years.
The anniversary of Facebook is also a kind of anniversary for myself. Broadly speaking, I have been championing the cause of social media for both healthcare and pharmaceuticals for a decade. It is now four years since I launched the first pharma disease-focused Facebook community that welcomed comments and engagement. So although it is easy to outline the massive impact online social networks have had on society at large, what has the impact been on health and pharmaceutical companies? The truth, in my opinion, is far more nuanced than the juxtaposition of the typical flag-waving evangelists and the head in sand conservative reactionaries. Here are my two-standout observations on a decade of health on Facebook:
1. The impact on public health
Perhaps the most powerful impact Facebook has had on healthcare comes as a natural consequence of the amplification of personal connectivity it affords, much the same impact it has had on other aspects of everyday life. Facebook has encompassed everything: From a gaming platform and messaging hub, to driving real-time ‘dating’ applications, disrupted advertising and retail, as well as influencing politics. It is no wonder it has had an impact on public health too.
At the most basic level, of the 1.23 bn people on Facebook, everyone will have had an illness at some time or another. And as the social creatures of Facebook do, with all aspects of life, they share these experiences, ask questions and support one another. Cardiologist and digital healthcare commentator Eric Topol rightly points out the capacity for healthcare professionals to deliver round the clock information about flu vaccines, the spread of epidemics and advice on preventative care using social platforms like Facebook. In truth though, this mostly constitutes a theoretic capacity that has been largely underused by either government or health bodies. There are examples of individual healthcare professionals engaging with patients using social platforms, but as with most things social, it is everyday people who have exemplified the impact of Facebook on public health.
Topol also described the story of a mother who posted pictures of her sick child on Facebook. People in her network started commenting on those photos and a cousin of the mother (who also happens to be a paediatric cardiologist) got in touch to say the boy might have a rare genetic disorder: Kawasaki’s disease. The mother called her doctor and said she was on her way to the hospital because she had a “sense her kid was really sick”.
Although unsure, she took her child to hospital and claims the doctor said, “You know what? I was just thinking it could be Kawasaki disease. Makes total sense. Bravo, Facebook.”
This kind of interaction, although mostly on a much less dramatic scale, is taking place everyday across the globe.
This amplification of the human support network is very powerful. Facebook themselves have also scratched the surface of the impact the network could have on public health. In May 2012 they made registering as an organ donor an official ‘Life Event’. On the first day of registration 6000 people signed-up to be organ donors in the US alone, the average number of registrations in the US at the time was only 360 per day. The initial impact may have tailed off but the opportunity was clear.
Although there are concerns about data privacy, the capacity for people to share basic health information, such as blood pressure, could have a positive impact on our scientific understanding of public health. It is also true that many hospitals are very active on Facebook (more than any other network) and leading lights such as Mayo Clinic use it to raise awareness about health initiatives such as mental health services, HIV testing or blood donation campaigns.
Pharmaceutical companies could conceivably use Facebook as a means of scientific research, and to better understand patients and their needs, but only really in partnership with Facebook. Facebook’s capacity to get tools and services into the hands of thousands of real people is an opportunity that did not exist 10 years ago, but is something that could be leveraged more. I even have experience of the success of using Facebook with getting self-assessment tools to 100,000 people in 3 months, as opposed to the previous measure of 400 per month through other digital channels.
2. Changing communication with the public for pharmaceutical companies
It is easy to stand here in 2014 and criticise pharmaceutical companies for a supposed lack of direct communication with the public and patients. In truth, although things may not have moved on enough over the last 10 years to satisfy those looking for even greater levels of engagement and support to justify the ‘patient-centered’ approach, a great many pharmaceutical companies have moved a long way.
In truth, when I worked in corporate communications and started to push the use of social platforms such as Twitter as a means of communicating to a broader audience, it was seen as unnecessary, possibly even dangerous. Pharma ‘communicated’ to the public and patients through advocacy groups and other trusted third parties. This meant they were by and large removed from the true feelings and even language of real people struggling with real conditions.
Over the last ten years pharma has essentially been forced to engage in real conversations about topics such as health reform, the HIV patent pool, transparency of data, and even television advertisements. The world has not collapsed, and in fact I am convinced that what Facebook represents, as the most popular social network, has evolved thinking on communication strategy for pharmaceutical companies. Gradually over the years strategy has moved to a place where the arguments are now ‘how can we be better at doing it’, not whether or not to do it at all.
I genuinely believe that if social networks, of which Facebook must be seen as the leading force, had not shifted the centre of gravity of power from large institutions and government organisations to the individual, then we would not have the current trend towards patient-centered outcomes and the push for larger real-world data sets. Andrew Spong MD at STweM sums it up nicely: ‘Facebook has taught people as healthcare consumers and patients to expect their voices to be heard, their opinions to be considered, and responses to their questions to be forthcoming.’