Facebook and Preventative Health: The Pros and Cons of the Facebook Preventative Health Tool
2020 has started and we all know what that means, time to organize our goals for the year, our agendas, our new years resolutions, and most importantly, set up our yearly wellness checks. For those of you who haven’t added this to your to do list or aren’t familiar with it, let me take a moment to share some knowledge with you. A wellness check is a yearly check that occurs with your primary care physician or another healthcare professional monitored by a physician. This yearly check is geared towards preventing diseases like heart disease, cancer, diabetes and other common diseases. This wellness check usually includes blood pressure check, blood work that checks for triglyceride levels, cholesterol, vitamin levels like vitamin D (among others things), sugar check, an ECG, and additional items depending on your gender and medical history. For females you will usually have your pap smear and for males usually a prostate exam along with checking your PSA levels. They will also review all your other preventative screening tests like the colonoscopy, and mammograms for women, as well as any other items depending on your medical history.
With life so busy, we tend to forget about these preventative screening appointments, and don’t make an appointment till someone reminds us, does it for us, or till we have symptoms. This year Facebook has decided to step into the public health world and send out reminders to their users regarding their wellness check and preventative screenings. The checkups recommended by Facebook are based on guidelines from the American Cancer Society, CDC, American College of Cardiology and The American Heart Association. Reminders like these on the bottom, will start popping in your news feed. The hope is that reminders like these will get people thinking of these screenings, and ultimately increase the number of patients screened.
And, while this is a good idea, and aims to try and increase the number of patients getting screened, it has raised some concerns in the public health community and healthcare community. One of the major concerns is that due to this being an app, HIPAA does not apply to Facebook’s preventative health tool. This leaves a huge door open to the sharing of identifying health information of patients. And as we know in the past year, Facebook has not done the best job of securing our private information. Unfortunately our information on Facebook has reached the hands of other companies like Netflix, Spotify and Microsoft without our consent. This has raised concerns of how safe our private health information will be.
On the bottom is one of my health checkups from Facebook. As you can see, in order for Facebook to know what screening you may need, you need to enter your age, gender, if you did the screening, and it follows by asking you to add a reminder for your next pap test/pap smear. If you have not done it, it ask that you add a reminder and gives you a list of locations near you where you can get the test done. This is the same protocol for all of the other health checkups recommended by Facebook, like the blood pressure check and cholesterol check. No test results or the exact location of where the test was done are shared with Facebook.
While the information given is limited and results are never posted on Facebook, Facebook also has other information of ours, like our birthday, name and at times even address. This information plus the information given in these health checkups are all identifying information that can identify a patient and part of their medical history, and because this isn’t covered under HIPAA, there is an opportunity that our health information could be shared with other entities without our consent.
Another concern from the public health community is misinformation. A Facebook user has the option to press on learn more as you can see on the top. This shows the user recommendations of when to get the exam, how the exam is performed, who can do it, and a list of common questions with answers. While this can increase the knowledge of a patient, it can also mislead a patient. One example, is the information regarding pap test. Facebook shares that one is needed every 3 years, and if one has a hysterectomy, this check up is usually not needed. This information can be a bit misleading, as this information is very general. Many of the times, women will have it once a year, depending on their medical history, and even if you have a hysterectomy, if you have a history of cervical cancer, a yearly pap test may still apply. It also mentions HPV test should start at 30 years of age generally. This can also be misleading as if there is a history in the family of HPV, this check up may be done at an earlier age. They also do not mention the HPV vaccine. Another misleading piece of knowledge is when to get blood test for cholesterol levels. It mentions if one is 20 years or older they should get it every 4–6 years, even though this is actually done yearly at every wellness visit, and at times may be checked more than once a year if the patient has a history of heart disease or hyperlipidemia.
This slides into another slippery slope and concern of not only the public health community but also the healthcare community, and that is the use of technology or apps, like Facebook, as a replacement for going to one’s yearly wellness checkup or seeing their healthcare provider.
Facebook needs to ensure that users know that this tool is not meant to replace visits to their healthcare provider, it is meant to stimulate them to see their providers.
And while it is not noted anywhere in the Facebook preventative health tool, they need to make sure to include that this tool is not a replacement for seeing one’s healthcare provider, and if any other concerns arise to go see a medical professional. They also need to be very careful on what educational information they are posting, and make sure that it is being posted by a healthcare professional and not just someone who is copying and pasting what google says.