Since the late 1990s, when I founded CREATION.co, I’ve been fascinated by how the Internet, and then social media, has empowered health stakeholders to connect, share knowledge, learn from each other.
The emergence of a new behaviour
Around a decade ago, we saw the emergence of a new behaviour: healthcare professionals were using social media to learn from each other, from the front lines of healthcare. As we talked with doctors about how they were using social media, they shared stories about integrating Twitter into their daily work lives: one senior emergency medic in Australia told me how social media had enabled a colleague to care for a patient with a gunshot wound, after he asked a question on Twitter and a doctor in another continent shared his experience.
Back then we were witnessing the start of a global movement of healthcare professionals, suddenly empowered by social media to learn and collaborate with each other. We saw that physicians, nurses, pharmacists were beginning to move beyond conversations with close peers or colleagues in their own hospital; they were tapping into the experiences and views of experts all over the world, and often in real time. These experts were often people they had never met, and did not know “in real life”.
This was an incredible opportunity for healthcare professionals, but also a real challenge. The online conversation was often taking place in full view of the public, so there were confidentiality issues; but there were also issues about credibility and authenticity of content being shared.
How could a physician know that the author behind a particular medical tweet or blog or discussion forum post was really a healthcare professional? Some health systems tried to bring order to this – in the UK, the General Medical Council, which regulates doctors, issued guidance on accountability, stating that doctors on social media should not be anonymous: if you say you’re a doctor, you should say who you are.
The guidance was virtually impossible to enforce, but in practice most doctors on social media were already using their real names.
The emergence of peer-to-peer trust and engagement indicators
As we studied the online behaviours of healthcare professionals using CREATION Pinpoint, we were able to measure indicators of peer-to-peer trust and engagement. We saw a kind of group consensus develop, whereby the credibility of an individual in the eyes of their online peers could be measured by factors including the responses, engagement and network that they were part of.
Simply because somebody posted a lot of content, did not make them credible; simply because somebody claimed to be a doctor, did not make them trusted.
But when a physician shared in open dialogue with peers, the credibility of their voice was tested by the network. Influence was determined by the “crowd” of other experts, in a type of mass peer review. So those trusted by other physicians developed a strong network of influence among their peers.
The emergence of Digital Opinion Leaders
This is how we saw the emergence of what we first called “Digital Opinion Leaders“, or DOLs. When a physician is trusted by their peers online, they can make a significant impact on learning, on health systems, and through this on health outcomes, often all over the world.
Of course those healthcare professional DOLs are part of a diverse global online network of health stakeholders. And this is where the voices of DOLs become powerful to make an impact way beyond themselves. We saw healthcare professional DOLs engaging with grass roots online patient movements; we saw them raising their voice on policy issues like access to medicines; and we saw them collaborate with industry for the greater good.
Over the past year, we’ve seen a massive growth in the online behaviour of healthcare professionals, as face-to-face contact has been restricted by the COVID-19 pandemic and more health stakeholders have turned to digital engagement. Today we are in a powerful new era for shaping health systems, and the role of DOLs is more important than ever.
Image: CREATION Pinpoint emerging global HCP social media networks presented at Stanford MedicineX in 2014.