Socialized health surveillance

By Bob Violino
04:41 PM

Two public-health-focused agencies, the Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) have launched efforts to use the latest Internet-based technologies to disseminate information about issues such as health hazards and food safety.

The FDA is using online tools including Twitter, blogging, podcasts, videos and widgets to provide information to the public in areas such as medical devices, FDA recalls, drug updates and animal health.

The agency began exploring social media about two years ago when it used a Twitter account"in conjunction with the CDC and the Department of Health & Human Services"to alert people about a recall of peanut products.

"We realized we could start educating the public in an effective way," said Sanjay Koyani, senior communications advisor at the FDA's Center for Tobacco Products. Social media is now "a critical piece of the FDA's interaction with the public," he said.

The agency had been using email applications to get the word out on news such as product recalls. But since a growing number of users prefer Twitter to receive news, the FDA decided to use that medium as well.

But while some of the benefits of the new social media tools are evident, so are potential negative consequences, and agencies are taking steps to minimize the risks. To sort through the dividing line between the risks and rewards of the new tech, the FDA has created a Web 2.0 Governance Council to plan and oversee its use of social media.

Recent efforts have included "bloginars" "Webinars designed specifically for bloggers"which the FDA has hosted to educate people on topics such as food safety and pet health.

One of the most aggressive FDA efforts to use social media is in the area of tobacco and its health risks. Largely in response to new federal regulations about the distribution and use of tobacco products, the FDA's Center for Tobacco Products uses online resources to spread the word about the regulations and the dangers of tobacco, Koyani says.

The center plans to use Twitter and Facebook, mobile applications and electronic games as part of a large national campaign to communicate with the public"especially teenagers" about the risks of tobacco use.

Koyani says the center hopes its participation in social media will lead more people to visit FDA sites, from which they can glean additional information. The center, along with other FDA groups, sometimes places content such as blogs on other government agency sites. "The public doesn't really care where it's coming from, as long as it's branded and relevant," he said.

CDC seasoned in social media
CDC is also increasing its use of social media tools, including Facebook, You- Tube and Twitter. "We want to provide credible, accurate and timely health information to citizens when, where and how they want it," said Ann Aikin, social media strategist at CDC. "Social media helps us meet this communication objective."

Over the past few years, CDC has integrated social media into existing campaigns, health communications efforts and emergency responses, according to Aikin. The organization regularly provides health information in popular social media channels. For example, recent efforts include a Twitter entry about food safety tips at summer fairs and festivals, and a podcast providing health information for children on a variety of topics.

Other efforts include bloginars on seasonal influenza, and an "Everyday Health Widget" that provides daily health tips. The CDC's most popular widget so far, one it created for the peanut product recalls, was placed on more than 25,000 Web sites in just a few weeks.

While government agencies are enthusiastic about social media they're also aware of the potential drawbacks. Just as the Internet can be used to educate people, it can also be a source of misinformation that confuses or misleads many people.

"The main drawback is the lack of peer review/vetting of claims," says Arthur Caplan, professor of bioethics and director of the Center for Bioethics at the University of Pennsylvania. "Anyone can post anything and does. The Web is a great place to start learning about health-related issues, but it is not by any means the place to end."

Aikin says CDC works closely with lawyers and security experts to ensure that it's doing what it can to minimize the risk of participating in social media. For example, all of the work CDC does on social media channels such as YouTube, Facebook and Twitter is done on off-network computers, "so we do not pose any additional risk to the CDC network," she says.

The use of social media at CDC also increases risk to CDC systems and data, Aikin says. Examples include public comments on blog posts, which are vulnerable to cross-site scripting or spearphishing attacks; malicious individuals who are accepted as "friends" and then change their profiles to purposely include malicious code or inappropriate content and malicious applications.

CDC views social media tools as a means of disseminating health information and key messages, and has determined that the potential risk of participating in social media sites is worth the potential reward, Aikin says.

Given the increasing use of these tools and the importance people are placing on them, "we feel that we would be running an equally dangerous risk to CDC's reputation if we were not taking steps to engage citizens in these new forms of communication and provide information to them in a meaningful format. Many of these media are changing how many people get their information and how they trust that information," she said.

But in spite of the potential risks, agencies view social media as the future of mass communication. "Many social media channels provide amazing reach and new ways to target and tailor information to diverse audiences," Aikin said. "Using social media also allows us [to deploy] tools that are already being used by a growing segment of the population, which helps us ensure that increasing numbers of people have access to our messages."