Abstract
Rossotti et al. have constructed a Facebook-based HIV education and counselling system which represents a new approach to the practice of clinical medicine and public health. 1 This scheme facilitates disease prevention and provides a platform for the evaluation of medical quality which will greatly assist in evidence-based health care policy making. Harnessing the Internet and social networking offers a new approach to health promotion.
The problems confronting health systems worldwide, which include rapid ageing of the population, overweight and obesity, chronic disorders, infectious diseases and health inequalities, are expected to remain challenges throughout this century. Cloud computing may enable more cost-effective applications by facilitating communication, information sharing, and record keeping regarding health and medicine. It allows the dissemination of information from one point to many, as does Facebook, which is currently the largest online social network. Specifically, combining cloud computing and social networking could allow the creation of a “Health Social Networking System” employing a human-oriented, interactive medical web. This would improve the establishment and maintenance of databases, and the quality of participants’ health information.
A powerful public health system is one that promotes effective disease prevention via an epidemiology-based policy-making framework and knowledge of the political framework. A Health Social Networking System could fulfil these requirements by facilitating access to and transmission of medical data, and the formulation of prevention strategies. First, in the primary prevention of common diseases and conditions, such as obesity, and the advocacy of important public health measures, such as smoking cessation, weight control and alcohol abstinence, social networking sites such as Facebook and Twitter could be used to propagate health information. This could take place on an unprecedented scale, and would also provide support for people facing these problems by enabling the formation of mutual friend groups. Although the use of Facebook in this way seems unlikely because of authorization, validity, confidentiality, cost-effectiveness and compliance problems, further investigation of this novel approach is justified.
Second, adding an option to indicate health status on social media sites would assist in the development of individualized therapy by analysing adherence to medications and a healthy lifestyle. For example, a person's vital data could be updated regularly from wireless home-based medical devices recording heart rate, blood pressure, serum glucose level, and even daily step counts and dietary diaries. The monitoring of these data by specialized management organizations that communicate any abnormalities to users and their physicians would further enable the development of population-based secondary prevention strategies. Third, tertiary prevention in dementia care could be revolutionized by incorporating social media into web mapping systems (e.g. Google maps) combined with the location data from GPS trackers carried by the patients. Enabling continuous data collection by social media could also facilitate epidemiological research, allowing the identification of the risk factors in common disorders and the development of the clinical profiles of rare diseases.
The development of a Health Social Networking System recognizes that accurate diagnosis and effective management is the cornerstone of contemporary medicine. By facilitating the transmission of electronic information regarding a patient's medical, family, occupational history and its integration with electronic datasets, such as geographical and atmospheric information systems, the use of a Health Social Networking System would provide a better estimation of environmental exposure to risk factors at the individual patient level. Moreover, access to precise, relevant clinical information would foster diagnosis, after which access to evidence-based medical databases and real-time expert counselling would facilitate the formulation of an individualized therapeutic strategy. Thus a Health Social Networking System would provide new pathways of communication between health care providers, and between patients and their health care providers.
The benefits of a Health Social Networking System also come with privacy and security concerns. However, the intensity of public concern may be no different to that expressed about information exchange via electronic medical records (EMR). From the technical viewpoint, it is essential that social networking services provide secure storage of health relevant data and ensure adequate access control. On the other hand, participants in a Health Social Networking System have the responsibility to learn how to use social networking services safely and decide on appropriate privacy levels. For instance, participants could decide to disclose their GPS locations only to close family members or to care providers that they trust. From the perspective of management and policy making, establishing effective legislation is the cornerstone of privacy protection and regulation. 2 Obviously, integrating Internet social media with current health information networks would challenge existing privacy rules. Governments and policy makers should therefore review potential deficits in the privacy laws as a matter of urgency, and prepare for information exchange through social networking services. 3
Now is the right time for the development of information communication strategies that bridge the divide between medicine and public health in a manner that facilitates large-scale health care intervention and management. Health care providers and stakeholders must seize the opportunity to apply the Internet and social networking to the construction of reliable databases that will assist in policy decision-making and health promotion. Also, governments and policy-makers should reconsider the legal consequences surrounding the rapid development of health information technology. By doing so, the promise of providing patient-centred/individualized health care can be fulfilled.