Virtual clinic shows value of peer support

study by the Warwick Medical School has identified community support amongst patients as a key benefit in a pilot Internet-based system to aid the management of diabetes.

The object of the study was to assess the feasibility, acceptability, and effectiveness of an Internet-based virtual clinic designed to facilitate self-management in patients who used insulin pumps to manage their diabetes.

Peer support

The study’s paper states that when peer-supported elements were incorporated into Internet-based interventions for diabetes, they are often the most-used components.

In many ways this is in line with the way the Internet’s social media concepts operate. In social media applications such as Facebook or MySpace, Internet users form communities united by a common cause or interest. People in these communities exchange ideas and often help each other through open conversations that other members of the network can contribute to (see our article on pharmaceuticals using Facebook for more on this).

This is good news for patients – the paper notes that community support is believed to be a fundamental aspect of disease self-management and points out that:

  • “The benefits of peer support in relation to health include: decreased feelings of isolation, promotion of positive psychological states and increased motivation, deterring maladaptive behaviours, and providing information on the benefits of behaviours that positively influence health.”

Better than healthcare professionals?

Interestingly, whilst all participants in the study highly rated the clinic in terms of improving communication with peers, few agreed it had improved communication with healthcare professionals.

Once again this confirms a phenomenon found in online communities: Internet users trust each other more than they do people outside of their peer communities. Perhaps this reflects human interaction offline too, but online the effect may be more pronounced due to the availability of information and the ability for the phenomenon to be measured.

Creation Interactive’s own earlier studies have also indicated that on the Internet, people trust each other more than they trust the ‘corporate’ face of healthcare providers or companies; however in the Warwick Medical School’s study we see that the effect goes further to place peers above even a patient’s healthcare professional.

That is not to say that the paper indicates the clinic’s patients did not seek advice from their healthcare professionals; it simply points out that in terms of online interaction they found the peer support the most useful. As the paper states:

  • The comfort they took in meeting others of like experience was expressed by two users who said, “just to have communication-to realise you are not the only person in the world like this”;”it has been so nice to realise that your problems are not unique and you’re not on your own trying to solve them”. This probably explains why the discussion board was the most used feature, with participants commenting that involvement was both “useful and reassuring”.

More than social media for health

We spoke with the paper’s author and part of the team behind the study, John Powell, MB, PhD, MRCPsych, FFPH, Associate Professor at Warwick University’s Warwick Medical School. He told us why social media is a particularly helpful platform for patients discussing their health.

“There’s a freedom to discuss online frankly without revealing your identity”, said Dr Powell, who has carried out earlier studies into the way patients interact online. “It’s about what you might not discuss with others face to face.”

Dr Powell says that earlier studies have identified three factors in online peer support that affect user behaviour:

  1. Universality of experience. People find it helpful to know that they are not alone.
  2. Installation of hope. Knowing that others have been through a similar experience, and knowing that they coped or survived, brings hope.
  3. Quality of empathy & interaction. People feel that only those in the same situation can understand. Peer patients understand because they have been there; they do not give ‘textbook’ answers that might be given by a healthcare professional who does not have the experience of being a patient.

In healthcare, Dr Powell says that these three factors are in addition to the usual appeal of social media for connecting and sharing experiences with friends. He points out that the Internet allows people to connect with others who are geographically dispersed but have the same condition. Even with rare conditions, you can find others with the same condition. So, he says, it is not just about communication with others, but communication with others with the same problems.

The future is digital healthcare

Dr Powell believes a time will come when the Internet is not only the first point of call for patients seeking medical advice, but when automated processes will provide an initial diagnosis, a GP appointment, or even an online consultation.

“With reducing costs of IT, improvements in connectivity, and the cohort of the younger generation growing up, barriers to using [the Internet for healthcare] will be gone. For people aged ten now, when they are in their 50’s and 60’s this will be normal”, says Dr Powell.

It will not happen overnight though. Dr Powell says that it will take time, and that processes for data security and information governance will need to develop. But he says he is confident that it will happen eventually:

“We’ll get there in a stepwise, slow progress. Because the NHS must give universal care, not excluding anybody who does not have access. So for now we will always need traditional ways of accessing health. But the reality is we’ll get there.”

What does this mean for healthcare today?

What can healthcare providers learn from this? Not only is the Internet user community ready and willing to receive healthcare support online, but there is evidence that the Internet is ideally suited to certain online interaction between patients. This creates immediate opportunities to engage patients on matters relating to their health and to build and interact with communities through a platform that many patients are already familiar and comfortable with.

Healthcare professionals should expect to see changes in the way they engage patients online, but they can rest assured that for the moment at least, their professional advice will still be sought in an offline environment.

If you would like advice about how the Internet could enhance the way you engage people about healthcare matters or healthcare provision, why not contact us to speak with one of our healthcare engagement experts?

We’d like to thank John Powell for taking the time to speak with us about the research and for sharing some of his additional insights. The full paper on the study can be downloaded from the Journal of Medical Internet Research.
Daniel Ghinn

Daniel Ghinn is Editor of Healthcare Engagement Strategy and CEO of Creation Healthcare, the online market research consultancy for healthcare. He is a prolific writer and speaker on emerging trends healthcare engagement in the digital age.