Social media usage among health care providers

Abstract

Objective
The objective of this study was to evaluate the use of social media among healthcare workers in an attempt to identify how it affects the quality of patient care.

Results
An anonymous survey of 35 questions was conducted in South Texas, on 366 healthcare workers. Of the 97% of people who reported owning electronic devices, 87.9% indicated that they used social media. These healthcare workers indicated that they spent approximately 1 h on social media every day. The healthcare workers below the age of 40 were more involved in social media compared to those above 40 (p < 0.05). The use of social media among physicians and nurses was noted to be identical (88% for each group), and both groups encouraged their patients to research their clinical conditions on social media (p < 0.05). A higher number of physicians reported awareness of a social media policy in their hospital compared to nurses (p < 0.05). However, a large proportion of healthcare workers (40%) were unaware of their workplace policy, which could potentially cause a privacy breach of confidential medical information. Further studies are required to evaluate specific effects of these findings on the quality of patient care.

Full text

Surani et al. BMC Res Notes (2017) 10:654
DOI 10.1186/s13104-017-2993-y
RESEARCH NOTE
Social media usage among health care
providers
Zoya Surani1, Rahim Hirani2, Anita Elias3, Lauren Quisenberry4, Joseph Varon5,6, Sara Surani7
and Salim Surani8,9*
Abstract
Objective: The objective of this study was to evaluate the use of social media among healthcare workers in an
attempt to identify how it affects the quality of patient care.
Results: An anonymous survey of 35 questions was conducted in South Texas, on 366 healthcare workers. Of the
97% of people who reported owning electronic devices, 87.9% indicated that they used social media. These health-
care workers indicated that they spent approximately 1 h on social media every day. The healthcare workers below
the age of 40 were more involved in social media compared to those above 40 (p < 0.05). The use of social media
among physicians and nurses was noted to be identical (88% for each group), and both groups encouraged their
patients to research their clinical conditions on social media (p < 0.05). A higher number of physicians reported aware-
ness of a social media policy in their hospital compared to nurses (p < 0.05). However, a large proportion of healthcare
workers (40%) were unaware of their workplace policy, which could potentially cause a privacy breach of confidential
medical information. Further studies are required to evaluate specific effects of these findings on the quality of patient
care.
Keywords: Social media, Healthcare workers, Physicians, Nurses, Depression, Policy
© The Author(s) 2017. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License
(http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium,
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and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/
publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Introduction
Seventy percent of Americans use social media and con-
nect with each other, currently, which can be compared
to only 5% of Americans, which used social media for
this purpose in 2005 [1]. Social media can be considered
one of the most innovative and one of the most destruc-
tive market forces which has emerged. Health care is
not immune to it either. Currently, more than 40% of
the health care consumers utilize social media for their
healthcare information needs. is being even more in
the consumers who are 18–24years age group, compared
to the 45–54year age group. 90% of the health care con-
sumers in the 18–24year age group utilizes and believe
health care information presented in the social media [2].
Whether through advertising or interactions with other
colleagues, hospitals and healthcare workers engage with
one another via social media in their work fields [3].
41% of the health care consumers chose social media to
decide on their health care providers. In addition 26%
of the hospitals in USA is currently participating in the
social media in some form [2]. Social media has provided
to be a communication system for healthcare workers
through which they can find patient health information
and past medical history or they can review relevant
information about illnesses [4]. In terms of benefits,
social media has provided healthcare providers a way to
overcome barriers in delivering healthcare to patients
[5], has enhanced self-management skills among patients
who can familiarize themselves with specific illnesses and
also provides numerous opportunities for providers to
conduct research in their relevant fields [6]. Some clini-
cians have suggested that social media is among the best
ways to design, collect, and analyze data into scientific
papers for academic journals [7].
However, potential harmful outcomes can result from
social media and should be considered, especially as they
Open Access
BMC Research Notes
*Correspondence: srsurani@hotmail.com
9 University of North Texas, 1177 West Wheeler Ave, Aransas Pass, TX
78366, USA
Full list of author information is available at the end of the article

Page 2 of 5
Surani et al. BMC Res Notes (2017) 10:654
relate to patient confidentiality [8]. Many hospitals and
practices have strict social media policies, but not all
employees are aware of them.
Additionally, age is thought to be directly correlated
with the time spent on social media [9]. One study con-
cluded that medical students, who are younger, spend
more time on social media as compared to the resi-
dents, which suggests this correlation [10]. Another
study showed that the use of social media among physi-
cians was 41% in 2010 and 90% in 2011, as compared to
medical students who usage was more than 90% [3]. us
taking into account the factor of age could help us nar-
row down the general age group to work with in order to
reduce the harmful effects of using social media during
working hours, as it could be the source of distraction.
Moreover, only 31% of healthcare institutions have social
media policy, per Institute of Health [2].
e purpose of our study was to understand healthcare
workers knowledge regarding the social media policies in
their institution; their utilization of social media and also
the utilization of healthcare providers above and below
the age of 40years of age, as the data has shown the uti-
lization of social media is significantly higher in popula-
tions below the age of 45years.
Main text
Study design
is study was an anonymous exploratory research using
sampling of convenience. It analyze the most commonly
used social media, estimate daily time spent on social
media between health care providers, analyze subject
awareness regarding their hospital’s social media policy,
and to see whether healthcare workers encouraged their
patients to use it as a tool to educate themselves regard-
ing disease process. An Ethics and Institutional Review
Board (IRB) of Corpus Christi Medical Center, Corpus
Christi Texas USA approved the survey and protocols.
Consent waiver was granted by the IRB. e survey was
carried out in a local community hospital and specialty
clinic of mid-size suburban town.
All health care providers in the coastal bend area of
Texas can be included. e healthcare providers who do
not desire to fill the complete questionnaire or unable to
read the questionnaires were excluded.
Methods
A sample size of 360 was needed based on the popula-
tion of the health care providers in the coastal bend
region of Texas to be 6000. A total of 366/370 healthcare
provides participated (Table 1). Since there was not a
validated questionnaire available, and being a pilot study,
the questionnaire, comprised of 35 questions was devel-
oped, after deliberating the questionnaire among the
investigators. ese questions were pretested among five
physicians and five nurses. ese were modified again
based on the feedback from this pilot group. ese ques-
tionnaires were anonymously distributed and collected
in the healthcare setting. e responses from the paper
questionnaire were manually entered and analyzed elec-
tronically, mainly using Microsoft Excel, Microsoft Cor-
poration, California USA. p values were calculated using
two-tail Student t test. p value of<0.05 was considered
significant.
Results
366 surveys were analyzed. 108 participants were male
(29.5%), 257 were female (70.2%), and 1 preferred not to
respond (0.3%) (Table1). Hispanics (43.0%) and Cauca-
sians (40.8%) dominated the sample size (Table1). 97%
of the sample size indicated that they own a type of elec-
tronic device. Of those 97%, 87.9% of indicated that they
used some kind of social media on a regular.
Out of 366 participants, 217 were under the age of
40, and 151 participants were over 40 (Table1). In the
Table 1 Demographics of participants
RN registered nurses, LVN license vocational nurses, CMA certified medical
assistants, PA physician assistants
Category Subcategory N (%)
Gender Male 108 (29.5)
Female 257 (70.2)
No response 1 (0.3)
Race African American/Black/Caribbean 12 (3.3)
Asian/Pacific Islander 40 (11.0)
Caucasian 148 (40.8)
Hispanic/Latino 156 (43.0)
Native American 2 (0.6)
Other 5 (1.4)
Age group < 20 0 (0)
20–29 92 (25.3)
30–39 123 (33.8)
40–49 64 (17.6)
50 +85 (23.4)
Job Physician 68 (19.0)
RN 151 (42.3)
LVN 10 (2.8)
CMA 6 (1.7)
PA 2 (0.6)
Dietitian 1 (0.3)
Speech pathologist 1 (0.3)
Pharmacist 5 (1.4)
Pharmacy technician 5 (1.4)
Physical therapist 7 (2.0)
Other 101 (28.3)

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Surani et al. BMC Res Notes (2017) 10:654
under-40 group, 91.2% of participants used social media
compared to 84.1% in the over 40 group. In < 40 age
group, 78.3% of participants used social media>30min
per day compared to 62.3% of participants in> 40year
age group. In>40year age group, 85.3% of participants
and 68.2% of participants in < 40 year age group have
been involved in social media for more than a year. Our
study also revealed that 71.7% of participants in the<40
and 42.7% in the>40 age group use social media before
going to bed. e statistical comparison on the use of
social media between these two age groups is shown in
Table2.
35.4% of healthcare providers indicated that they spent
31–60 min/day, 32.0% selected < 30 min/day, 16.8%
selected 61–90min/day, 8.1% selected 91–120min/day,
and 7.8% selected>2h/day.
Among daily users of social media, 76.5% of the partici-
pants spent<10% of the time on social media for work
related activities, whereas 1.7% indicated their use was
mostly work related. 32.3% of the participants indicated
that their use of social media is a waste of time.
As per their institutional social media policy, 40.8% of
subjects were unaware of the policy’s existence.
Of the physicians and nurses, 66% indicated that
patients could access their medical records online, and
42.8% encouraged their patients to become familiar with
their maladies by reading about them online.
Differences in the use of social media were found
between the physicians (n=69) and nurses (n=152) in
the sample population (Table1). e use of social media
among physicians and nurses was observed to be identi-
cal at 88% for each group. While 10.4% of physicians con-
tributed to medical forums online, only 3.3% of nurses
indicated the same. Information available online regard-
ing disease processes was considered reliable by 37.9%
of physicians compared to 47.5% of nurses, and 61.5% of
physicians and 56.8% of nurses encourage their patients
to search about their illnesses and diseases processes
online. Awareness of the hospital’s social media policies
was reported in 72.2% of physicians compared to 38.2%
of nurses. A statistical comparison is shown in Table3.
is study indicated that even though less than 50% of
physicians and nurses believed that online information
on disease processes was reliable, both groups encour-
aged their patients to pursue it (Table3).
Discussion
Social media, and the internet in general, is expanding
rapidly all over the world [11, 12]. In our study, 87.9% of
the participants indicated the use of social media, which
is similar to prior studies [13]. e use of social media
in healthcare settings is increasing daily as it pertains to
community engagement, promotion of health, patient
education, outreach, and various other factors. e con-
sumers are now driving the increase usage [14, 15].
To provide protection for the privacy of patients’ medi-
cal records, a law was enacted by the United States Con-
gress in 1996 known as e Health Insurance Portability
Table 2 Statistical comparison on the use of social media between two age groups (< 40 and > 40 years)
* p values < 0.05
# Item description < 40 years of age (n = 217) (%) > 40 years of age (n = 151) (%) p values
1 Do you use social media? 91.2 84.1 0.036*
2 More or less than 30 min? 78.3 62.3 0.00070*
3 Involvement in social media (< 1 year or > 1 year) 85.3 68.2 0.00008*
4 Do you think you waste your time on social media? 31.3 33.8 0.62
5 Do you use social media before going to bed? 71.7 42.7 0.000001*
6 Do you think social media takes away from your family time? 14.4 20.8 0.11
7 Do you get less sleep because of using social media? 16.6 15 0.68
Table 3 Statistical comparison on the use of social media between physicians and nurses
* p values < 0.05
# Item description RN (n = 152) (%) MD (n = 69) (%) p values
1 Use of social media 88 88 > 0.05
2 Do you contribute to medical forums online? 3.3 10.4 0.03*
3 Do you think information on social media is correct? 47.5 37.9 0.53
4 Do you recommend your patients to search about their illness online? 56.8 61.5 0.02*
5 Are you aware of your social media policy? 72.2 38.2 0.000008*

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Surani et al. BMC Res Notes (2017) 10:654
and Accountability Act (HIPAA) (Centers for Disease
Control and Prevention (CDC) [16]). e consequences
in the breach of privacy can be severe and may lead to
civil or criminal penalties [17].
Social media can also be a large distraction in the work-
place. With all the perks of accessing medical records
easily through different websites or applications, it is
also highly tempting to use that resource for recreational
purposes during work [18]. One study showed that when
Facebook™ use was allowed in the workplace, productiv-
ity decreased by 1.47% [18]. In another study, institutions
that allowed their participants to use Facebook™ every
day for 15 min demonstrated a decrease in work effi-
ciency by 1.5% [19].
Our study suggests that social media is an important
tool for healthcare providers to help familiarize patients
with their clinical conditions. is is especially beneficial
for those who are unable to access healthcare informa-
tion easily, including ethnic minorities and lower socio-
economic groups [20]. In one study, 53.5% of the patients
who participated, indicated the use of social media for
medical and health information [21]. However, social
media may be deleterious for patient care.
To our knowledge, there are no previous studies quan-
tifying the number of healthcare providers recommend-
ing the use of social media to their patients. We found
that nearly half of participants (42.8%) encouraged their
patients to read about disease processes on social media.
Our study suggested that a large number of healthcare
workers are unaware of the social media policy at their
workplace. is is worrisome because understanding
institutional policies regarding social media is crucial in
protecting confidential medical information and avoiding
HIPPA compliance issues. Moreover, if healthcare pro-
viders are unaware of their social media policy, this can
affect medical professionalism as a whole. It is important
to note that though unintentional, this example is a viola-
tion of HIPAA, which restricts an individual from post-
ing medical images to protect patient privacy [22]. Even
after organizations such as the AMA provided these
guidelines, not many healthcare providers are aware of
or in compliance with their social media policies [23]. In
one study, only 54% of healthcare institutions surveyed
had a social networking policy [24]. Our result is consist-
ent with these data (59.2%).
Some studies have shown that the use of social media
decreases with age [25]. In one survey, 83% of the partici-
pants who were active users on social media were under
the age of 30years [25]. In our study, healthcare work-
ers below the age of 40 used more social media and spent
considerably longer amounts of time on it compared
to healthcare workers above the age of 40 (p < 0.05).
ese differences are multifactorial. In our study, more
healthcare workers who were above the age of 40 indi-
cated that social media takes away from their family time.
Conclusion
e use of social media in our cohort was in line with the
general public. However, our study suggests that physi-
cians contribute to medical forums online more than
nurses. More than half of physicians and nurses encour-
aged their patients to learn about their disease processes
online, however, only a small percentage believe that the
information regarding the illness is reliable, which in
contrast to what the consumers believe. Further studies
are needed to determine the impact of social media on
patterns of healthcare quality and disparities of care.
Limitations
Small sample size, encompassing single community hos-
pital and clinic limits it results to be applied to the larger
population. Moreover, cultural and geographical differ-
ences among population across the world may limit the
generalization of this paper and hence similar studies
in multiple geographical locations are required. Study
design being sampling of convenience, also places some
limitations. Not having a validated questionnaire also is a
limitation of this study. We though suggest development
of validated questionnaire and conducting a randomized
trial to address this important issue which health care
industry is facing.
Abbreviations
USA: United States of America; IRB: Institutional Review Board; CDC: Center for
Disease Control and Prevention.
Authors’ contributions
ZS, LQ, SS1 and SS2 were involved in design, data collection, data entry and
preparation of manuscript. JV was involved in study design and preparation
and review of manuscript. RH and AE were involved in preparation of manu-
script. All authors read and approved the final manuscript.
Author details
1 Veterans Memorial High School, Corpus Christi, TX, USA. 2 School of Natural
Science, Hampshire College, Amherst, MA, USA. 3 Sanamed Education, Miami,
FL, USA. 4 Texas Tech University, El Paso, TX, USA. 5 The University of Texas
Health Science Center at Houston, Houston, TX, USA. 6 The University of Texas,
Medical Branch at Galveston, Houston, TX, USA. 7 Harvard University, Cam-
bridge, MA, USA. 8 Texas A&M University, Corpus Christi, TX, USA. 9 University
of North Texas, 1177 West Wheeler Ave, Aransas Pass, TX 78366, USA.
Acknowledgements
Not applicable.
Competing interests
The authors declare that they have no competing interests.
Availability of data and materials
The raw data can be obtained from the correspondence author.
Consent to publish
Not applicable.

Page 5 of 5
Surani et al. BMC Res Notes (2017) 10:654
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Received: 30 June 2017 Accepted: 25 November 2017
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