The future of health care communication and promotion.

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 healthcare policy making. Harnessing the internet and social networking offers a new approach to health promotion. The problems confronting health systems worldwide, which include rapid aging 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 formulation of prevention strategies. First, in the primary prevention of common diseases and conditions such as obesity and in 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 those 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, diet diaries and even daily step counts. 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 such as 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 patient’s medical, family and occupational history and its integration with electronic datasets such as geographical and atmospheric information systems, the use of a Health Social Networking System at the individual patient level would provide a better estimation of environmental exposure to risk factors. Moreover access to precise, relevant clinical information would foster diagnosis. Following diagnosis, access to evidence-based medical databases and real-time expert counselling would facilitate the formulation of an individualized therapeutic strategy. By such means, access to a Health Social Networking System would provide communication among healthcare providers and between patients and their healthcare providers in new ways. The benefits of adopting 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 must provide secure storage of health relevant data and must assure adequate control of access. 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 simply disclose their GPS locations to close family members or 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 social media with current health information networks would challenge existing privacy rules. It is therefore urgent that governments and policy makers should review potential deficits in the privacy laws and prepare for information exchange through social networking services.[3] It is now 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 healthcare intervention and management. Healthcare providers and stakeholders must seize the opportunity to utilize social networking and other web services to construct reliable databases that will assist 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-centered, individualized healthcare can be fulfilled.