“Banning access to internet social networking sites – don’t throw the baby out with the bathwater”

Actions to prevent NHS and other workers accessing internet social networks have been widely reported in the national news media1-3. These actions addressed reasonable concerns about IT security and lost productivity. Nonetheless it would be a great shame if they stigmatised internet social networks and obscured their potential benefits for both patients and health professionals.

For the uninitiated, internet social networks are communities of disparate individuals using websites to create and share interests, ideas and information. These websites exploit multimedia communications to provide users with access to content rich in detail and variety. Well-established internet social networks include Facebook (http://www.facebook.com), Bebo (http://www.bebo.com) and MySpace (http://www.myspace.com). They are regarded as attracting mostly younger users and perhaps inevitably some content is a little too rich for mainstream tastes. However, reports of the demographics served and participating can be surprising – according to Forrester Research, Facebook users have ‘aged’ over the past year with the number of users aged 35 or over, increasing from 36% in August 2006 to 45% in August 2007. Nevertheless, internet social networks arguably offer an unprecedented scale and speed of information sharing⁴. Content is not usually subject to formal peer or editor review, but this need not diminish its value, especially when human experiences, which can provide vital context for information, are being shared.

Patients with chronic diseases have an enormous capacity to care for self-care and mutual support. Many associations, such as the National Kidney Federation (http://www.kidney.org.uk/), include user-lead internet discussion and information-sharing forums. Other internet social networks including Daily Strength (http://dailystrength.org/) cater for many different conditions within a single social network. Some of these networks use cutting edge web 2.0 technology. The American Cancer Network has recently opened a virtual health and education facility which caters for the ten million virtual inhabitants of the ‘Second Life’ world and their ‘actual’ alter-egos (http://slurl.com/secondlife/American%20Cancer%20Society/131/63/23).

Internet social networking also offers new information sharing opportunities for clinicians. A recent BMJ article highlighted the benefits of social networking in scientific discovery⁵. Social networks can also benefit those involved in health service improvement. Clinicians across the NHS are striving to improve services, often in isolation from colleagues who face the same challenges in other organisations. Internet social networking offers the opportunity for such individuals to collaborate rather than to work in isolation, often reinventing wheels and repeating mistakes. The Sermo social network (http://www.sermo.com/) offers such a service for American clinicians and the NHS Institute for Innovation and Improvement is currently developing and testing a purpose-built Internet social network to serve users within its organisation and as a pilot for an existing defined clinical community of practice.

As is often said, new technologies don’t solve all our problems; they just create a better set of problems. It would be a great shame if recent events stigmatised a new technology before we’ve even begun to realise its full potential. Information security and productivity are of vital importance to the NHS, but let’s not throw the baby out with the bathwater.

Yours sincerely,

Dr Simon Watson

Dr Donal O’Donoghue

Dr Mark Greenhalgh

1 Facebook banned by Health Trust. BBC News online 5^th September 2007 (http://news.bbc.co.uk/1/hi/england/kent/6980736.stm)

2 Facebook addicts costing businesses £123m each day in lost productivity. Daily Mail 6^th September 2007

3 Facebook ban for ‘half of all staff’. Daily Telegraph 24^th August 2007

4 Kelly,K. We are the Web. Wired Magazine, 13(8) 2005 (http://www.wired.com/wired/archive/13.08/tech.html)

5 Cohen, D. Facebook for scientists?. BMJ 2007;335:401

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Source: Nielsen / NetRatings – Forrester Research, quoted by David Erickson on October 20, in e-Strategy.com’s Internet Marketing Blog: http://www.e-strategyblog.com/2007/10/facebook-demogr.html