Now I'm relatively new to Twitter (and haven't quite got the hang of Facebook, don't use Linked In to its full potential, haven't even got a Pinterest account and love Citeulike...etc...etc) but some of the most interesting conversations that I've been following have been about HCSM and HCSMANZ - health care and social media.
There's a real sense that something new is about to happen, that social media has the potential to revolutionise communication and engagement in health care, across services, between different professionals and, most importantly for patient engagement in their health care and health services. Increasing effective engagement and enablement of patients could really improve health outcomes. That, I think, is really worth working towards, and social media could really help this to happen.
And now comes my but. But.
I'm writing this watching multiple tweets fly across my timeline. Twitter is such an active medium, there is so much going on, that it can seem like that's all the activity there is. But I'm thinking of some recent people I've met and onversation I's had.
A elderly neighbour is writing a history of doctors in our local area and has asked me to look at the manuscript. It's printed out on paper from an old word processor, with a hand-written cover note.
A tech-savvy senior health care manager isn't sure how o operate twitter.
Many of my patients have no computer at home, don't have a smart phone, and struggle to operate the phone they do have. Difficulty paying bills means phones often change numbers, or are cut off or not used for a time.
My local library has a sign up saying their computers are not to be used for Facebook or Twitter.
These experiences are summed up in two really important bits of research looking at the digital divide, or who doesn't have good access to computers and smart phones. In essence, it's not surprising that those on lowest incomes have least access. But the important thing about this is that those on lowest incomes also have the highest health care needs.
So, think of the elderly, with a range of co-morbidities, really needing to be engaged in high quality health care, who might, like I heard someone say this week, just say "Facebook is stupid".
Think of many Aboriginal and Torres Strait Islander people, who through reasons of geography, money, literacy or health problems may find engaging online very difficult.
Think of those with health problems or disabilities - who, by definition need health services - who may have difficulty using the technology simply becuase of their health (my elderly neighbour mentioned above has quite severe rheumatoid arthritis).
My plea, then, is to make sure, when moving forward into the bright, engaging future of using social media in health care, that we check the rear view mirror every so often to see who we might be leaving behind. We won't find them on twitter. We might not even find them in our clinics. But they are definitely out there, and need to be enaged just as much to get good health care.
P.S. Thanks to these tweeps for a conversation on this topic, too: