Should hospitals use Facebook Groups for online patient support?
During the Facebook debate at last week’s MCSMN conference, I made the bold statement
“It is unethical, even dangerous, for hospitals to use Facebook Groups for peer-to-peer support groups.”
Given the rules of debating, my arguments were one-sided. I was playing a role. It is naturally more nuanced than that. Some hospitals are using Fb Groups very successfully for patient support. However, I warn that the Fb Group functionality as you know it now will not be the Fb Groups of tomorrow. Fb Groups are not the only option for online support groups. Before defaulting to Facebook, consider the landscape carefully.
1. Facebook is NOT free. Sure it appears to be free on the surface, but what are the hidden costs? As Facebook pivots their business model towards groups, I predict that even closed groups will be subject to more advertising and algorithms that will control who sees which posts in the group feed. Remember what happened to Pages.
2. Facebook’s algorithms typically favor positive sentiment. Ever noticed how the word “Congrats” appears in bold red?
Consider this scenario: A group member posts “I just finished chemo and rang the bell.” This post will undoubtedly get many likes and congrats, boosting it repeatedly to the top of the feed and garnering increasing attention. But what about the member who just joined and posted this? “Just had my second round of chemo. After a day of vomiting and nausea, it’s all I can do to write this post. I can’t go on.” Will Facebook suppress the negative sentiment? We don’t know.
To quote a colleague, Michelle Hamilton-Page, “Facebook is like a serotonin hit from the candy of congratulations.”
3. Facebook rewards activity, but doesn’t recognize quality of posting.
4. Fb Groups are pitiful at maintaining history and archiving collective knowledge. The Search function is mediocre. Rather than adding to an existing discussion that already has meaningful posts in it, the platform functionality encourages and rewards members who start new posts. Thus veteran members find themselves sharing the same beginner- or new-member information over and over again. They grow tired of this and move on. And you are left with a retention problem. Successful support groups rely on elders to mentor newbies.
5. With Fb Groups, you have little to no control over design, UX functionality or metrics to make the platform work for your community members. It’s a rental property. So you can’t evolve with the members as the sense of community deepens and matures. Facebook caters to the inception phase of a community, but good community management strives to move from inception to establishment to maturity.
6. Facebook has already proven unreliable in keeping information confidential. Closed groups give a false sense of security.
While at Facebook headquarters last January attending a Health Stakeholders workshop, I was very impressed with the Facebook employees as they shared their aspirations for the development of Groups in health and learned from health community leaders. They genuinely want to do good because they have witnessed great things that happen when patients and caregivers share with each other. But if Groups become the core of Fb’s business, I worry about the lack of control you will have when connecting patients on a rental property.
What has been your experience with Facebook groups? There are great examples out there. I’d like to hear how you mitigate the concerns.
Do you or your clinicians ask to open a Facebook group? Do you? Should you?