Beyond Communication: Social Media Can Help Pay Your Health Care Bills!

Just a few weeks ago, I recapped the "Top 3 Pop Health Trends in 2013".  Topping my list was the intersection between social media and public health.  I've written about using social media for everything in public health from advocacy to emergency response to surveillance.  So I was intrigued to see a recent story that highlighted another innovation:  allowing patients to use social media to pay for health care services.

The "Pay-With-A-Tweet" program was launched by Telecure as a way to market their telehealth services.  They link California residents with an urgent care provider within 15 minutes of their call.  Clinicians are made available to callers via phone or video as a way to reduce access to care barriers.

The "Pay-With-A-Tweet" program will waive the $25 consultation fee if patients share their experiences on Facebook or Twitter.  According to media reports on the program, the idea blossomed after Telecure officials noticed that patients were discussing their experiences on social media.  Creating a formal program allowed Telecure to (1) take advantage of social media marketing and (2) provide those short on cash with an alternate way to pay for care.

Telecure's CEO told mHealth News that the program's goals are currently to "stimulate awareness and growth".

I'd be interested to see how Telecure is evaluating this program and hope to see some follow-up press or research that documents the strengths and challenges of this strategy.

Some thoughts that come to mind for me:

• To tweet or not to tweet?  How do patient concerns about privacy contribute to their decision to participate in this program?  Many patients may not want to share with their social networks that they've been consulting with a physician (regardless of the diagnosis)- is that a barrier to taking advantage of this program?

• Is social media heavily utilized among their target populations (patients in remote locations and under served patients)?  What do those user patterns look like?

• How are tweets/facebook posts about negative experiences being handled?  Are negative posts still being promoted along with positive posts?  How are Telecure officials monitoring posts for customer service problems that may have occurred?

• How are tweets/facebook posts being promoted to the public?  For example, I searched several hashtags on twitter after seeing the media coverage (e.g., #telecure, #paywithatweet) but was not able to find any results that included reviews of their services.  If they are using social media to market services, they will want the patient posts to be easy to find! 

What Do You Think?

• Is using social media for payment an effective strategy to engage these and other target populations?
• What other evaluation questions/considerations should be raised in addition to those I've listed above?

From The West Wing to the National Health Care Debate

Anyone who knows me well knows that "The American President" is one of my favorite movies. If it is a favorite of yours as well, you may recognize that the actress who plays Press Secretary Robin McCall also plays National Security Advisor Dr. Nancy McNally in "The West Wing". The actress is Anna Deavere Smith.

This week in my "Qualitative Research Methods in Community Health" class, we discussed ethnography. Specifically we discussed Ms. Smith's work as an example of performance ethnography. For over a decade, she has interviewed people across the country and used the "data" to develop a one-woman show. Her newest play is called "Let Me Down Easy" and its goal is to show the human side of the national health care debate. I highly recommend viewing the 10-minute excerpt and interview here.

I'm so sorry that I missed her play when it came to Philadelphia earlier this year because I think it is an amazing example of the richness of data collected using qualitative methods. It is often argued that qualitative methods are too "soft" and limited in view. I've heard them described as "basically just journalism". However, I would argue that qualitative methods are essential to the success of public health.

Instead of surveys and databases, these methods collect data via interview, discussion, and observation. The research is meant to discover the complex relationship between personal and social meaning, individual and cultural practices, and the material environment or context. In contrast to what we have learned since grade school science about the scientific method and generalizability of findings- here the focus is on obtaining a deeper understanding of a population or phenomenon.

Ms. Smith conducted over 300 interviews for "Let Me Down Easy" and ultimately condensed her findings to show the experience of contemporary health care through the eyes of 20 individuals. These kinds of stories are incredibly powerful in public health. They open our eyes to challenges that we never would have found via survey...because we wouldn't have known to ask the right questions. They allow us to share stories with policymakers so they can see the impact of their decisions beyond the sterile statistics often cited. They can allow us to explore experiences or illnesses that occur in too small a population to survey.

Ideally, quantitative and qualitative methods should be used together to create the strongest public health research design possible. It should not be us vs. them...but instead a joint effort. I encourage us all to see the human side of health care reform when Ms. Smith's play airs on PBS "Great Performances" next season.