This document discusses strategies for designing online communities to facilitate care in healthcare. It defines social interaction design as creating dynamic ecosystems that support community, conversation, and collaboration. A model of conversation is presented involving goals, context, language, symbols, reactions, responses, and agreement. Considerations for healthcare communities include various stakeholders and their interactions. Design considerations center around identity, interests, groups, trust, reputation, conversation, privacy, and allowing the community to evolve organically. The goal is to design systems that empower patients and facilitate what emerges within the community.
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But first....
But first....
A participant (think patient, family member, care provider) has a goal, in this case their goal is to engage in social activities with other people around health & wellness - like cronic conditions
The participant chooses a context - and this is very important - just like when your boss calls you into his office and closes the door - that frames the kind of possible conversations that might happen.
Same thing when dealing with health related communities. If the context is an online community for parents of children with autism - that frames the expectations, kinds of conversation, types of interactions that happen.
The participants must negotiate a shared language. Right now clinicians define the language - it’s not patient-centric - in a language that patients would understand - it needs to be a language that is human.
Participants begin to the exchange of symbols - in the offline word those can be body language, but in mediated space, we lose all of that, so we develop a semiotics of conversation best suited to the environment.
agreement or understanding may be reached, or the transaction of some value may occur - like
“Wow, your hot, lets go back to my place for a nightcap”
In Social Experience Design - we have 7 key attributes that shape the design of online communities - each community is different and features/functions must map to these attributes.
Community: Online and Local Live Connectors
Organizational (The System): Digital access to caregivers, health coordinators, health coaches, nutritionists, nurses
Interpersonal: Support tools for family and friends, weaving them into the experience, interventions
Individual: Goal setting and tracking (where they are – SMS, iPhone, etc), personalized program and messaging, health games, health journals, HRAs, PHRs, messages to myself.
Baseline data is being gathered and the people are helping each other.
Can the system:
Help the user to notice and track the positive
Reinforce the positive in order to promote repetition
Provide guidance, include support team and introduce professionals at certain points
Track behaviors through and integrate with native communication channels: email, text messages, instant messages, twitter, facebook
Take pictures of your food – nutrition and portion size analyzed for feedback
Take pictures of your walk – it get’s reflected back to you
Personalized outreach messages, communication plan to yourself
Dr. and patients can log in to review lab results and xrays, via screenshare or live appointment
Log in to take a pre-visit questionnaire, fill out forms, and create questions for your doctor
View doctor’s notes from visit, (OpenNotes) and follow up care plan, track against it
Dr. access to your health journal
Ongoing dialogue with Dr: check in to review progress, leave notes, system can escalate, interventions
Connect with Dr. online via email, instant chat, SMS, online visit
College kids don’t want to water-down their conversations because their mom is now their friend on Facebook - multiple contexts have collided as people are connecting to their family, children, coworkers - there is no delineation, no semi-private space. For Communities of Care to be truly engaging, the context has to be clearly defined so people feel comfortable discussing personal, often emotionally charged topics.
My participation in online social media is informed by my sense of self and self image
I actively create, maintain, tweak, and monitor my online Persona
I have a self-interest in seeing my online presence acknowledged and reflected back to me
I use social media as an extension of myself, often telling about and narrating biographical details and reflecting how I would like to be seen
In the health & wellness space, I may be very sensitive to self image, self perception, acknowledgment, status, position, success
People gather around shared interests, passions, goals - this forms the context for sharing. This is not goal or activity centered design - because there is no end-state for engagement.
Know when I am online. Know when others are as well, and the degree to which they are willing to engage.
Social ties are complex. People want to gather around cronic conditions, around shared interests as well - the community of care must allow for sub-groups to develop organically. For groups around cronic conditions, this is where the care team can/should/must contribute.
Patients that are sharing their personal information need to know it won’t be traded upon. This trust only develops over time - and it only takes 1 time to destroy it. Trust is not transferrable and is completely dependent on context.
People make mistakes - reputation system & mechanisms to save face and repair a tarnished reputation.
One of the mechanisms we designed into Gather was the ability to earn points based on positive contributions to the community. Those points are redeemable for prizes, gift cards, and cash.
Yelp.com has a sophisticated reputation system for rewarding good behavior, as does eBay. A means of introducing feedback loops into the system.
Any community has it’s own sense of time, and conversations have a tempo, velocity, and flow.
Design for conversations - understand how they work, the mechanisms, the value.
People have boundries. Patients & people need to be able to have different types of conversations based on their closeness with other people in social media.
People need to have granular control over what their connections can see - this includes profile information, but also Who I follow, who follows me, what conversations I am engaged in. Patients managing their persona & conversations in the context of cronic conditions must trust the system is designed for this.
A grammar - set of rules - and community managers or high-trust people to oversee the conversation - make sure people are behaving - people are engaging in a positive way
surface compelling, active or high velocity discussions allows more rapid engagement
surface people that share interests so people can serendipitously connect.