Published on March 17, 2009
SOCIAL MEDIA FOR HEALTHY COMMUNITIES Michael Hardey Hull/York Medical School and Dept of Social Sciences University of Hull
HEALTHCARE IN 21C The third industrial (and therefore, healthcare) revolution is driven by citizens, IT and knowledge. Professionals are by and large two decades off the zeitgeist and this is not restricted to healthcare, it’s seen across all professions.’ ‘In the past we’ve given knowledge to clinicians who’ve then passed it on to patients, now our principles are that we give knowledge to patients and give them the opportunity to discuss it with clinicians Sir Muir Gray – Chief Knowledge Officer, NHS. www.worldhealthcareblog.org/2008/03/12/citizens- knowledge-and-the-appropriate-use-of-technology/
NHS HEALTHSPACE Better information, better choices, better health (NHS 2004)
INTRODUCING JOHN John (40) has diabetes. He has registered a profile of interests on HealthSpace, his own secure personal health organiser on the internet. Via HealthSpace, he regularly receives updates about diabetes and consults his online self-management training course and interactive care plan. He has setup his mobile so (via a blue tooth wristwatch) it keeps a check on his blood pressure, cholesterol and blood-sugar levels. John’s mobile also keeps track of his location, monitors his activity level and prompts him to do his daily run. At home John’s ‘smart’ fridge keeps track of his food and orders that it places with Tescos. Strain gauges in his shower floor check his weight, sensors in the toothbrush monitor the composition saliva. Infrared transmitters and sensors also check the state of his gums. The ‘intelligence toilet’ has a urine analyser and checks such things as sugar levels, albumin levels and so forth. All this data is added to his NHS Care Record, and checked against past results. Software sorts the data and informs John every day about his health status.
JOHN IN THE COMMUNITY John works in local government and his employer has given him the added benefits of the ‘healthy employer’ initiative. This means that the canteen has a lunch ready for him, devised from HealthSpace data sharing, and the coffee machine limits him to only one cappuccino (low fat) a day. However, being rejected by the lift, because he benefits from the a daily walk up the stairs can be irritating. John has been know to spend too long in the local pub but the publican, through ‘pubnet’, knows that has he is only allowed to be to drink up to 3 pints a week. The pub has signed up to the ‘healthy pubs’ initiative, which like the ‘healthy supermarket’ initiative shares information with HealthSpace. The city CCTV system also helpfully tracks John and he knows it will get his mobile to warn him if he happens to stray into a pub at the weekend. In any case CCTV facial recognition software will send data to the pub’s tills making an alcoholic drink expensive for John. A benefit of the ‘Your health, Your Lifestyle’ policy is an additional tax that is automatically added to items so that people like John are encourage to consume healthily and responsibly.
JOHN’S LEISURE TIME Like many people John lives in a ‘Healthy City’ where real time data from pollution monitoring stations are streamed to mobile phones that can warm the owner if air conditions, where they are, falls below optimal levels for them. The newly available (in the UK) crime maps helped John choose a home in an area he felt would be safe for himself and his kids, when they came over at weekends. Wanting to be a good parent John has signed up to the gallery and amenities information alerts system that prompts him if there is a new exhibition or if he has not visited a particular museum in the past month. Graffiti can be a problem and John has recently posted a picture of some near his home on a council Web site to ensure it will be cleaned off. John always uses his store card and credit card when he is shopping and out in the city. He often checks the ‘you might like to try this’ suggestions on his MacBook before he goes shopping. Experian uses code to sort all the data from John and ‘people like John’ so that it can offer recommendation that help reduce the risks of making the wrong consumer choices. However, John usually checks the community health restaurant map that tags restaurant details of health reports
JOHN’S SOCIAL LIFE In common with others John uses YouSpace as his SNSs. The official UK SNS, YouSpace makes it easy for him to pay his TV licence, manage his ‘GreenBin’ waste allowance and leave helpful comments about his experiences of government services. However, he is careful leave nice comments about his GP just in case he might have to wait longer to see him - like his mate Dave (who posted a critical note about Dr. Smith’s odd sense of humour and lack of empathy). Being currently single John is a member of DateMe, which is a part of the ‘healthy relationship’ initiative. This takes much of the effort out of creating a profile as it is partly generated by HealthSpace and YourSpace data. John’s data is processed together with other members’ data to achieve the optimal healthy relationship matches. Following the inter-departmental database sharing policy John’s dates know that he has a good sexual health record and no history of relevant criminal activity. Despite a number of dates John has not ‘clicked’ with anyone so has made some use of the ‘sexual exercise’ material that HealthSpace data has already downloaded from iTunes onto his Apple TV device.
PEOPLE LIKE JOHN Do not want to be dependent on ‘services’ however well delivered Do want the tools to do the job themselves Do want a focus on the person not the condition Expect to use and contribute to – blogs, wikis, user review sites e.g. ‘iwantgreatcare’, ‘ratemd’, ‘NHSChioces’
JOHN’S MUM IS ALSO SHARING DATA…
PEOPLE NOT LIKE JOHN? Want to be cared for Do not use information technologies Expect practitioners to understand when and how they can self-manage and support them to do so Risk becoming ‘system outcasts’ e.g. less ‘good’ services for those not engaged with social media - as those like John experience better services
THE TWO FACES OF JOHN Surveilled subject Self-managing individual Constraints – ‘a puppet of the system’ Choices and personalisation Volunteered data sharing Dataveillance Public services orientated to people - Public services orientated to policy, not conditions services, and targets Opt in settings Default settings to service provision Contributes user-generated – controls User- generated information ‘risky’ - data own data useful Sensibility of participation – user led Sensibility of top down – collaboration expert/professional led health Service users as productive participants – innovators Service users as patients/clients Professionals as : Professionals as : experts with access to advocate, navigate, counsel, risk abstract systems, gatekeepers, assess, broker, design providers of information and services ‘Share data and I will choose what and ‘Give us your data - we care for you’ when to share and who to collaborate with’
FINALLY These slides will be posted to ‘slideshare’ My email is: email@example.com c.uk Related forthcoming paper ‘informatisation of welfare’ in British Journal Of Social Work – special issue on new technologies
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