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DOI: 10.25136/2409-7144.2023.3.39904
EDN: NEOJIT
Received:
06-03-2023
Published:
11-04-2023
Abstract:
Interaction with patients, the quality of communication with them by medical professionals affect the results of treatment. In the digital era, new formats and channels of interaction are emerging, which are successfully used by medical organizations in the process of communication with consumers of medical services – patients. Among a wide range of online tools, social networks have become a phenomenon. The subject of the study is the communication of a medical organization with patients in social networks. The purpose of this article is to analyze the audience of medical organization communities in social networks using the example of a specialized federal medical center in St. Petersburg to determine how the characteristics of the audience of social networks correspond to real patients of a medical institution. This study is based on the analysis of cancer incidence statistics in Russia, content analysis of the communities of a medical organization specializing in Oncology in social networks. Author studies the role of social networks and online interaction in the era of digitalization. Using methods of analysis and synthesis, content analysis, systematization, generalization, a judgment is formulated on the compliance of the audience of medical organization communities in social networks with the real characteristics of patients. It was revealed that the audience of thematic communities of a specialized medical center in social networks corresponds to the characteristics of real patients of the institution, as well as morbidity statistics in the country. The results of the study can be applied by medical organizations in the process of building a communication process with patients. The novelty, uniqueness of the work and the contribution of the author to the consideration of the question posed consists in conducting a comparative analysis of the demographic and geographical characteristics of real oncopatients and subscribers of thematic communities in social networks.
Keywords:
interaction with patients, communication with patients, doctor-patient communication, social network, social media audience, audience of a medical organization, communication in healthcare, communication in medicine, digitalization, digital space
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IntroductionEvaluation of the effectiveness of providing medical care to the population, qualitatively high results of the therapy are achieved, among other things, due to the high level of adherence to the treatment of the patients themselves – compliance with the prescriptions and recommendations of a specialist doctor about taking medications, medical diet, modification of the daily routine and lifestyle. All this is possible only in the case of a sufficiently high level of trust in the doctor on the part of the patient and, as a rule, is accompanied by a high level of patient satisfaction with the treatment performed or conducted. Accordingly, in order to increase the effectiveness of medical care, it is necessary to increase the overall level of patient adherence to treatment, i.e. work on increasing the level of trust in doctors on the part of patients and their level of satisfaction with treatment. In the context of digital transformation, the expansion of the level of automation, the introduction of electronic formats of interaction in the provision of medical services to the population, new opportunities for communication with patients, new formats and communication channels have appeared. Before the advent of social networks, doctor-patient communication was available only within the limits of a direct medical appointment, or when patients read articles, studies and other works of specialist doctors in print publications, today the possibilities for this type of interaction are multiplying due to remote technologies and a wide range of online tools, including social networks.. The majority of Russians (62%) have accounts in social networks, about half (45%) of citizens over the age of 18 use them almost every day [1]. Social networks in the field of healthcare have developed and improved over time due to different forms of participation and the level of contribution of various stakeholders – medical organizations, doctors, public authorities, patients. Social networks, social media communities on medical topics are used as a communication channel to inform and facilitate the exchange of knowledge between various participants in the process of medical interaction. Over the years, the Internet, including social networks, has become one of the significant factors in a more patient-oriented healthcare model [2]. In addition, over the past few decades, medicine and medical organizations have become increasingly open to the general public and interaction with it. Thus, according to Federal Law No. 323 FZ "On the basics of protecting the health of citizens in the Russian Federation" dated 21.11.2011, medical organizations are required to inform citizens, including via the Internet, about their medical activities, medical staff of the organization, their level of education, qualifications, etc. [3]. Researchers and communicators in the field of healthcare, representatives of medical organizations need to understand how the audience of online interaction (in particular, social networks) corresponds to the real audience of medical institutions, i.e. recipients of medical services, patients, and their relatives. To manage communication with patients and expand the audience, it is proposed to analyze subscribers of thematic communities in social networks and assess how well this audience correctly reflects the needs and expectations of society, the information needs of patients. With this information, medical organizations have the ability to influence the level of trust in doctors, patients' adherence to treatment, and the possible strengthening of the role of online communication. Thus, we consider it necessary to assess the role of online communication in the field of healthcare, in particular, in the aspect of the use of social networks; to conduct a demographic analysis of patients with oncological diseases in Russia; to compare the characteristics of patients with the audience of specific medical communities on the topic of "oncology" in social networks for a certain medical organization. Online interaction of a patient with a medical organizationThe role of the media environment as a source of information is currently increasing for people of any age category, corporate communications in social networks are playing an increasingly important role in the modern media system, and Internet communication in general often replaces offline interaction [4. p. 101, 5. p. 483]. Every year, the number of types of remote interaction between doctors and patients is growing, i.e. communication through telephony, online technologies and online tools, including social networks. The importance of the development of medical topics in the aspect of high-quality publications from medical organizations, qualified doctors and professional communities in social networks is currently due to the fact that in social networks from users, researchers observe pronounced criticism of the current state of medicine in Russia [6. p. 86]. The audience of popular social networks, the number of authors in these social networks, the number of users of Internet sites, personal accounts on sites of various subjects, and even the number of registered email accounts on various services continue to grow annually, and the time that users spend consuming content via mobile devices also increases [7, 8, 9]. Many formats of interaction with the target audience, consumers of certain services are gradually moving from personal interaction to the online environment. Due to the fact that social networks offer a comfortable platform for interaction between the public, patients and medical organizations, the use of social network capabilities is becoming more common in the healthcare sector [10]. Traditional channels of communication between patients and doctors are transformed into an online environment and are implemented in the form of remote consultations through telemedicine systems, electronic information materials, social networks, official websites and blogs, webinars and recordings of online broadcasts (Table 1). Modern communication channels allow you to expand the reach of the target audience, provide medical care to more the number of citizens from distant regions. Also, many of them allow you to reduce the time of the doctor and the patient for traditional actions (for example, the time to travel to a medical institution). | Traditional communication channelsModern online communication channels |
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| Direct communication during the reception of specialists | Remote consulting through telemedicine technologies | | The need to go to the polyclinic to close the sick list | Closing the sick leave online or by phone call, using the Public Services portal | | Informational printed products: leaflets; posters; brochures (memos) | Electronic information products: brochures (memos) in formats available for download on a personal computer or smartphone; useful infographics | | Articles in newspapers and magazines, books | Mass media, official websites of medical institutions and blogs: articles, video interviews and reports, live chat option on official websites of organizations | | Television | Social networks: articles, video interviews and reports, short expert publications, podcasts, live broadcasts, online broadcasts, webinars for a wide audience | Table 1. Traditional and modern communication channels of medical organizations with patients. Compiled by the author
The development and popularity of social networks contributes to the fact that in the search results of popular browsers, when searching for information about a particular medical institution, among the first positions of the search results (in addition to the official website and SEO-optimized sites at the user's request), in most cases, the accounts of the organization in social networks turn out to be. For example, according to the search queries "St. George's Hospital" and "Petrov Oncology Research Center" in the Yandex browser, on the first page of the search results, among the first 6 links, 2 official accounts in social networks indicated in the search for medical institutions are displayed (Fig. 1, Fig. 2).
Fig. 1. The first page of the search results in the Yandex browser for the query "St. George's Hospital"
Fig. 2. The first page of the search results in the Yandex browser for the query "NMIC Oncology Petrov"
NMIC of Oncology named after N.N. Petrov is a federal specialized medical institution located in St. Petersburg, annually providing care, including high–tech, to thousands of patients from various regions of the country, as well as dozens of patients from other countries [11]. Patients with malignant neoplasms are provided with specialized and high-tech medical care: surgical, medicinal, radiation and combined treatment. NMIC of Oncology named after N.N. Petrov actively interacts with patients online and offline, including developing its website, blog, accounts for patients in social networks [12, 13, 14, 15]. The audience of the institution's communities is active: users leave comments, share community records on their pages, mark "I like", ask questions of interest to them and receive answers from representatives of the medical institution. Thus, more than 240 unique visitors are recorded daily in the community of NMIC for patients on the VKontakte social network. During the period 01.01.2023-31.01.2023, 399 new subscribers joined the community, 4,924 unique users visited the account, who left 158 comments and viewed publications 13.9 thousand times (Table 2). Over 6 months, community publications gain more than 88 thousand views, about 3 thousand new subscribers are recorded, more than 1.5 thousand comments.
Also, NMIC accounts in social networks play the role of a "transitional platform" between less formal communities of interest in social networks and the official website, the call center phone. For example, during the period 01.01.2023-31.01.2023, more than 240 interactions with action buttons, 160 transitions to the official website and more than 20 direct calls to the contact center number take place in the NMIC community for patients on the VKontakte social network. | Characteristics of interaction with users of the VKontakte communityMonthly value | Unique visitors (average, per day) | | | 243 | | New subscribers | 399 | | Views, thousand | 13,9 | | Dialogues (total) | 35 | | Dialogues (new) | 51 | | Comments | 158 | | Useful actions: action button | 244 |
| Useful actions: website | 162 | | Useful actions: phone | 22 | Table 2. Statistics of interaction with users, the NMIC community in VKontakte (data as of 31.01.2023)
Cancer patients in RussiaAccording to the data of the statistical collection "Healthcare in Russia", regularly published by the Federal State Statistics Service, the statistics of the incidence of malignant neoplasms in the population are as follows: in 2020, 556,036 people were registered with diseases in patients diagnosed for the first time in their lives, of which 256,069 patients are men and 299,967 patients are women [16]. | Age0-14 years old | 15-19 years old | 20-39 years old | 40-59 years old | 60 or more | Total | Men | | | 0,3% | 0,1% | 1,4% | 11,0% | 33,2% | 46,1% |
| Women | 0,3% | 0,1% | 3,2% | 14,9% | 35,5% | 53,9% | | Total | 0,6% | 0,2% | 4,6% | 25,9% | 68,7% | 100% | Table 3. Cancer incidence statistics in Russia according to age and gender, 2020, in %
So, about 2/3 of all cases are citizens over 60 years old, about 95% are over 40 years old. Women make up 54% of all cases. For the period 2020-2022, from 6 to 8 thousand patients receive inpatient treatment at the NMIC annually, and the number of hospitalizations totals more than 12 thousand annually. During the 10 months of 2022, 171,597 applications from 50,948 patients were registered in the outpatient diagnostic units of the Center. In addition, in 2022, the specialists of the center conducted more than 5 thousand telemedicine consultations, 70% of which took place in the form of a consultation (2 or more specialists were responsible). In 2022, the planned indicator of the proportion of patients from the regions who should receive inpatient medical care at the N.N. Petrov Oncology Research Center was 60%. The share of patients living on the territory of other subjects of the Russian Federation (all except St. Petersburg) and who received inpatient medical care at the N.N. Petrov Oncology Research Center during 9 months of 2022 was 65.5%. Patients living in the Northwestern Federal District (except St. Petersburg) and receiving inpatient medical care at the N.N. Petrov Oncology Research Center during 9 months of 2022 accounted for 33.2% of the total number of patients. Comparison of the audience of social media communities and patients of a medical organization
The largest community of the N.N. Petrov Oncology Research Center in social networks is the VKontakte group [13]. As of 01/31/2023, it has 28,124 subscribers, 86% of whom are women and 14% are men (Fig. 3.). These demographic features of community members correspond to the general trend of distribution of users of social networks and subscribers of communities of a certain topic by gender, since women are more active users of the VKontakte social network, often consist of in a larger number of thematic groups and communities than men, they publish more often in their profile, actively use the functionality of the social network based on their needs [17. p. 639]. According to Rosstat data for 2019, 57% of Russians aged 55 and older who use the Internet use social networks, and among the most popular services received by the older generation through the Internet are services in the field of health and medicine (35%) [18]. The distribution of community subscribers by age and gender corresponds to the statistics of cancer incidence in Russia: most of the subscribers are women, and more than a third of them are over 45 years old, slightly less than a third are between the ages of 35 and 45. 
Fig. 3. Distribution of members of the NMIC community in VKontakte by age and gender
According to the "geography" of the participants, 94.65% of the subscribers of the community are from Russia, about 1% from Belarus, 0.5% each from Germany and the Netherlands, the rest from other countries of the world. This distribution corresponds to the order of the ratio of the number of Russian patients and patients from other countries. Slightly more than half of all community members are residents of St. Petersburg, 6% are residents of Moscow. 3.1% are residents of Arkhangelsk, 2% each are residents of Cherepovets and Petrozavodsk, the rest are residents of other cities (Fig.4).
Fig. 4. Distribution of members of the NMIC community in VKontakte by city The second most popular community by the number of subscribers of the N. N. Petrov Oncology Research Center for patients and their relatives is the channel "Honestly about Cancer" on Zen. Platform [15]. As of 01/31/2023, the channel has 5,243 subscribers and 571 active subscribers for the week (11%). 82% of the audience of readers of the channel "Honestly about Cancer" are women, 18% are men (Fig. 5). Statistics are similar to the data of the NMIC community on the VKontakte social network and correspond to the distribution of cancer incidence in Russia: most of the subscribers are women, and the age of 45 years and older. 
Fig. 5. Distribution of the audience of the channel "Honestly about cancer" by age and gender Among the readers of the channel "Honestly about Cancer", 20% of the audience is from Moscow, 10% – from St. Petersburg. 3% of readers are residents of Nizhny Novgorod, Yekaterinburg and Novosibirsk, 2% of readers are from Samara and Chelyabinsk, the rest are residents of other cities (Fig. 6). 
Fig. 6. Distribution of the audience of the channel "Honestly about cancer" by city
After analyzing the subscribers and readers of the community on the VKontakte social network and the Zen channel.On the platform of the federal specialized medical center in terms of data on demographic and geographical characteristics, the level of audience activity, methods of informal interaction with representatives of a medical institution, it is fair to conclude that, in general, the characteristics of the audience of a specialized thematic community correlate with the demographic and geographical characteristics of real patients of the specified medical institution. The conducted research of the audience of thematic communities in social networks suggests that there are opportunities to expand the reach of the audience of users potentially interested in information materials published by medical organizations. This, in turn, can contribute to raising awareness and health literacy of the population. The creation and development of social networks by organizations providing medical services to the population can expand the possibilities of wider use of medical information for planning medical care, as well as more accurately communicating it to recipients of medical services – patients [19. C. 2233]. DiscussionThe difference in the data obtained in the context of demographic characteristics of cancer incidence in Russia and in the analysis of the audience of the communities of the N.N. Petrov Oncology Research Center in social networks in the direction of a larger number of female subscribers than female patients is explained by the fact that the participants of the communities in some cases are not the older patients themselves, but their children and grandchildren, mostly daughters, as well as spouses of cancer–stricken men and mothers of children diagnosed with cancer. They ask questions in comments, personal messages and online broadcasts about the disease and treatment options for their loved ones. In addition, as noted earlier, the male audience in social networks is less active than the female one. All the statistics of the communities of the N.N. Petrov Oncology Research Center in social networks described in this study are presented as of 01/31/2023.
Results and conclusionsIn the realities of the modern digital society, the conditions for the implementation of the principles of digital healthcare, a significant part of patients' communications with medical professionals, with specialist doctors is moving to the online space. Social networks, along with a number of other remote and electronic channels and tools of interaction in the field of healthcare, are becoming one of the most important informal ways of communication between medical institutions and patients. Today, social networks open up opportunities for patients to search and analyze various kinds of medical information, bypassing most of the traditional limitations of the healthcare sector. Despite this, medical information available to patients through social networks rather complements traditional sources of medical information, but does not replace them. The article analyzed the statistics on the incidence of cancer in Russia, assessed in terms of the compliance of demographic and geographical characteristics of real oncopatients and subscribers of thematic oncological communities of the Federal medical institution in St. Petersburg - N.N. Petrov Oncology Research Center. The analysis showed that the audience of readers and subscribers of the respective communities is similar (adjusted for the difference described in the "Discussion" section) with the characteristics of oncological patients of NMIC, citizens with oncodiagnoses in Russia.
Thus, the study on the example of a specialized federal center for the profile "Oncology" showed that the audience of thematic communities of oncological topics for patients and their relatives is similar to the audience of real oncopatients who receive specialized medical care in a particular medical organization. It is necessary to conduct further research in order to determine the presence or absence of a similar correspondence for audiences of other medical communities of various specializations and directions. It seems that social networks and their capabilities today can be successfully used by medical organizations to interact with patients, bring important information to them, form adherence to treatment, increase the level of trust in healthcare workers, which, together, can positively affect the results of therapy. The topic requires further research and development, more detailed empirical research.
References
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First Peer Review
Peer reviewers' evaluations remain confidential and are not disclosed to the public. Only external reviews, authorized for publication by the article's author(s), are made public. Typically, these final reviews are conducted after the manuscript's revision. Adhering to our double-blind review policy, the reviewer's identity is kept confidential.
The list of publisher reviewers can be found here.
In the peer-reviewed article "New tools for working with patient satisfaction in the digital age: the phenomenon of social networks", the subject of research in fact became the representation of people with cancer in the audience of the social network space. Thus, the subject of the study was not reflected in the title of the work. The purpose of the study is to analyze the audience of thematic communities in social networks to assess how well it correctly reflects the needs and expectations of society, the information needs of patients. The methodology of the research in the form of theoretical and methodological approaches is not specified. The paper uses an empirical method of analyzing thematic communities in social networks. Such an analysis is conducted with respect to the N.N. Petrov National Research Medical Center of Oncology, a federal specialized medical institution located in St. Petersburg. The paper analyzes the data of web analytics of the social network VKontakte and Yandex.Zen. The data are compared with statistical data on the incidence of cancer in Russia according to age and gender. In the context of the expansion of electronic formats of interaction in the provision of medical services to the population, new opportunities for communication with patients have appeared. This actualizes the problem of representation in the audience of thematic network communities of patients with relevant diseases. The scientific novelty of the publication is not obvious. It is very controversial to conclude that the distribution of community subscribers by age and gender corresponds to the statistics of cancer incidence in Russia, since the data presented in Figure 3 and in Table 3 structurally coincide only with respect to women (but not for men). Although, in fairness, it should be noted that the author himself in the discussion section tries to explain the difference in the data obtained in terms of demographic characteristics of cancer incidence in Russia and when analyzing the audience of the communities of the N.N. Petrov National Research Center of Oncology on social networks towards a larger number of female subscribers than female patients. It is also doubtful that the conclusions regarding the thematic community on cancer can be extended to all medical communities. This requires a more correct formulation of the conclusion. It should be noted that the importance of the general conclusion that social networks can be successfully used by medical organizations to interact with patients, bring important information to them, form adherence to treatment, increase the level of trust in healthcare workers, which, together, can positively affect the results of therapy. This study is characterized by general consistency and literacy of presentation. The content meets the requirements of the scientific text. The article will be of interest to researchers in the field of health sociology and SSM specialists. The bibliography of the work includes only 13 references, with only one to a scientific publication. This does not allow us to recognize the appeal to the main opponents as justified. Conclusion: The article "New tools for working with patient satisfaction in the digital age: the phenomenon of social networks" has a certain scientific and practical significance. The work can be published after 1) bringing the title of the work in line with the subject of the study, 2) formulating conclusions adequate to the study, 3) supplementing the bibliographic list with works in the field of research of thematic communities in general and medical orientation in particular. Comments of the editor-in-chief dated 03/21/2023: "The author has finalized the manuscript in accordance with the requirements of the reviewers. The work is recommended for publication"
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The article "Comparative analysis of the audience of the medical organization's communities on social networks and its patients" is devoted to the urgent problem of improving the quality of medical services using digital technologies. The subject of the study is the socio–demographic characteristics of the audience of online interaction (in particular, the VKontakte social network and the Yandex Zen platform) and the target audience of oncological medical institutions (recipients of medical services: patients, their relatives). However, the subject of the study is not formulated in the text of the article, which leads to confusion of concepts: firstly, the author has not specified the target audience of oncological medical institutions (in the reviewer's opinion, in the case of such a life-threatening and expensive treatment category of diseases as oncological, the target audience should include not only patients, but also their relatives and friends). Elderly patients, who make up the majority of cancer patients, are accompanied in medical institutions by relatives who also communicate with doctors; secondly, the author's choice of social networks as the only tool of digital communication "doctor-patient" is surprising. It should be more about social media: response sites, blogs, public channels, messenger chats, etc. The author's attribution of the Yandex Zen content platform to the category of "social network" is questionable. At the same time, the analysis does not include the Odnoklassniki social network, in which the representation of older age cohorts is wider compared to VKontakte, and, theoretically, closer to the profile of the target audience of the Petrov Oncology Medical Center. Such popular social media as "Prodoctors" with 18 million visitors per month and reviews of about 700 thousand doctors remained outside the scope of the study. These social media allow us to effectively measure the level of trust in doctors on the part of patients and satisfaction with treatment. It is advisable to eliminate these remarks both in the title of the article and in the text. The author conducted an empirical study of the characteristics of the audience of subscribers of the group "NMIC of Oncology named after N.N. Petrov" VKontakte and the channel "Honestly about cancer" on the Zen Platform by means of appropriate social media options. The article attempts to compare these data with the official statistics of the incidence of malignant neoplasms in the population. However, two methodological problems impede the implementation of this idea: 1) in addition to patients, the audience of social media includes their relatives; 2) empirical sources use different scales to measure age. VKontakte's algorithms do not allow us to identify age cohorts of subscribers over 45 years old, but it is this audience that needs segmentation to achieve the goals of the study. The sample of VKontakte group subscribers is very strongly biased towards the female audience. All this makes the author's conclusion about the correspondence of the distribution of community subscribers by age and gender to cancer incidence statistics in Russia empirically absolutely unjustified. The relevance of the article is beyond doubt, since the social reality in a digital society is changing under the influence of high technologies, and these changes require sociological understanding. The scientific novelty lies in an attempt to expand the tools of social management through new information technologies. The article has a clear structure, divided into semantic and methodological parts. It would be necessary to define the basic concepts: "social network", "community" and "audience", to justify the sample of the study. The article is written in a scientific style, the terms and definitions in the text are used correctly. The bibliography corresponds to the subject and is presented quite fully. No conclusion has been drawn based on the results of the Zen Platform audience analysis, the conclusion based on the results of the VKontakte audience analysis requires clarification. The article will arouse the interest of the readership in eliminating these shortcomings.
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