There are lots of obvious pitfalls with healthcare communications and privacy issues abound, but when it comes to developments affecting healthcare online, Foursquare is definitely one to watch. If every campaign and brand is only just now jumping on board Twitter and Facebook, Foursquare could very easily become the next ‘me too’. That is, if it isn’t happening already…?

All you need to do is text ‘follow [username]’ to 40404 and all the updates will come to you as text messages. To find out more, such as how to turn the function off and on as and when you want it, give the Twitter blog a read.

This is the start of a big conversation that has significant implications on the NHS and public health. We’ll be following closely, and recommend others to do so and get involved too…

There is nothing to suggest people are going to stop using social media because some long forgotten (but reassuring) concept of privacy will all of a sudden return. Fears are often quickly calmed when the ‘reasons for’ come in, and the bottom line is that if people see the benefits of these systems and genuinely want to use them they will be willing to take a little bit of risk. It’s likely we’ll see more educated users of social networks, but if people are willing to share with trusted parties where they are on a map, they are going to be willing to share sensitive healthcare information if approached in a professional, trustworthy manner and there are clear benefits to be gained.

The theory behind the initiative is that teenagers are more likely to play games on computers or mobile phones than they are to watch educational programming. So Channel 4 is trying out ways to make the most of their education budget by experimenting in this area (more information on this in a detailed article by The Guardian).

There is a thriving industry out there of games developers making this software specifically for healthcare campaigns , as we discovered just by reaching out on Google. These games can be really effective, although there are a few golden rules we’d think would be essential:

•  Relevance: Pretty much rule number one. ‘Privates’ will work for a select audience of teenage boys, but as one commenter on The Guardian article put it nicely, “playing games inside a vagina … I wonder whether this will appeal more to boys than girls”. If the target audience in this case is girls (which we can only assume it is not), this is obviously a bad route. Similar Flash games suit audiences perfectly, like these particularly cute but shocking heart operation games by the British Heart Foundation. Children play games like this and would definitely engage in them
• Integrated publicity: Like any online health awareness campaign, there must be something driving traffic to the site, such as a wider public relations campaign with engaging spokespeople, patient case studies and the like
• Educational/recreational balance: Are the learning objectives going to be achieved best by a game or through peer to peer consensus around an issue, which might better be achieved through social networking or a more traditional media outreach focus? One issue with Flash games is whether the educational content will just be skipped through. If so, perhaps there is some ‘subconscious’ learning occurring, but if a game can have an unobtrusive, in-built evaluation mechanism (like a knowledge test), it would be an excellent way to ensure the objectives are achieved

There’s one further issue to consider with these games, and that’s the incompatibility of Flash with Apple iPods, iPhones and iPads. For some audiences, you might be better off developing an app, although the great thing about Flash is that you can use it on most computers by going to a webpage, rather than having to download an app.

The over-riding consideration to come back to is always that games like this can be good content, but without some strong educational context, ‘edutainment’ is at risk of becoming exactly what it’s detractors think it is. But if it’s done right, you have the potential to captivate a large new audience, and have a lot of fun at the same time.

Brands like Starbucks reward fans who ‘like’ the page with customer discounts. Many brand Twitter feeds do the same. While this is not permissible in most healthcare scenarios, the concept of ‘giving something back’ fosters loyalty and encourages communities to form. So it’s something any healthcare Facebook page should keep in mind (although the application of the concept will obviously vary).

So how does a brand update its status on the Facebook wall? A brand can hardly say the same things a person would. But Skittles manage to come up with the funniest and charming updates which invoke curious people looking in to respond. Fond examples are ‘High fives should always be followed by guitar solos’, ‘Shark Week is pretty awesome, but Shaolin Ferret Week is even better’ and our favourite, ‘Belly button, eh? I just call it a Skittles holster’. Give a brand a personality, and people engage with the personality, and as a result, the brand.

You might ask ‘This is all very well, but what about healthcare Facebook pages?’ If you haven’t yet done so, Jonathan Richman’s Dose of Digital page has the best three Facebook healthcare pages listed (as voted in the Dosie Awards). One example is The Coalition To Prevent Deep Vein Thrombosis, an unbranded page by Sanofi-Aventis in the US. It does not allow comments on products, which could easily be done in the UK, but it does motivate an entire community of people who have been touched by the condition. It reflects the personality of those in the community itself – one of determination, motivation and an urgency to do more for people affected by DVT.

Clearly the motto is meaningful engagement is key.

On a simple level, we believe that the pharma industry should be able to provide information to patients when appropriate. This is comparable to other industries. For example, when buying a car most people will initially develop a shortlist based on the brand’s advertising that most closely reflects their own values (such as safety, reliability or status). But because buying a car is a major investment it’s likely that the purchaser will also look to other sources for confirmation that the decision is the right one. When the claims the manufacturer makes are also backed up by Jeremy Clarkson and What Car? the brand and environmental messages are congruent and a purchase is more likely to occur.

While healthcare is very different, the principle is similar. In the same way that a car manufacturer knows more about their cars than anyone else, a pharma company knows more about its drugs than anyone else. Therefore, a pharma company should be able to share information about medicines with healthcare professionals and patient groups if appropriate of course always complying with regulatory obligations. We are not talking about direct to consumer advertising or direct communications with patients – this is something we’re more than happy we do not have in the UK. We are simply talking about the pharma industry providing balanced information in an appropriate manner to complement the information provided to patients by patient groups and healthcare professionals, such that patients are able to make well informed choices about their healthcare.

The point here is that the knowledge pharmaceutical companies have about their medicines should not be kept locked away, but communicated to healthcare professionals, and in some cases patients, in an appropriate and responsible way. If initiatives funded by a pharmaceutical company enable greater insights into the management of a condition, this can obviously benefit patients. In our opinion, it is not a question of whether pharma should be able to provide information to healthcare professionals and patients when appropriate, it is how they do it and what the information is.

The idea of customising viral videos to individual users is not new. MySpace ran a video in which your MySpace or Facebook profile picture becomes a framed picture Alisha Keys sings love songs to, or that 50 cent places on his wall. It was a big internet hit.

The return on investment for Old Spice will be phenomenal. Although we might be talking about a completely different setup for healthcare, there is still potential here. It’s all about thinking a bit laterally, being brave enough to become slightly detached from brand and product and create positive perceptions about an idea or subject.  More please…

Whether patients want ‘choice’ or not, they will become increasingly immersed into a healthcare culture which says they should. They are being promised an ‘information revolution’ to give greater control of medical records and access doctors online, as well as the services of HealthWatch, a new agency to handle patient complaints and champion the views of the public across health and social care.

So how can healthcare communications support patients and bring value to this new NHS? In many ways. But here are just a few ideas to start with:

- Patients are likely to be confused about what they are being promised and what it actually means when it comes to their specific condition and healthcare needs. Pharma partnerships with trusted third parties could provide guidance on how to make the most of the services out there.

- Engagement programmes could teach patients how to make the most of their personal healthcare budgets supporting websites and social networks which allow the exchange of information about specific services would provide useful feedback and insights.

- Working with patient groups to obtain feedback on local services and if appropriate, assisting in lobbying activities could make positive changes to the new system, while building  trust.

- Holding many small scale patient or healthcare professional feedback events, with Twitter feeds around the events to inform the outside world, could tap into opinion and generate advocacy around healthcare issues.