What Factors Generate Trust in Healthcare Capabilities?

Using Digital Ethnography to Explore Healthcare Experiences

Online spaces are increasingly important nodes of social contact. As researchers, our methods need to reflect changes in human behavior. Our blog has previously approached this topic by showcasing our work using mobile ethnography. Now we’d like to share our findings from a recent project using digital ethnography.

What is digital ethnography?

Digital ethnography is ethnography conducted through digital means.

Ethnographic material can be drawn from online communities, blogs, chatrooms, social media or any other kind of digital source.

There are downsides to conducting ethnography digitally instead of in-person. For instance, the researcher is unable to see and interpret bodily gestures and visual cues.

However, digital ethnography also provides substantial benefits. For instance, this method:

• Provides access to hard to reach populations (geographically or in terms of how marginal the topic is)
• Removes the need for recruitment (as participants are already discussing the topic of interest)
• Minimizes the impact of research processes on results (as answers arise in previously existing contexts)
• Provides quick access to massive amounts of data

How can digital ethnography be applied to generate insight?

MDRG recently used digital ethnography to better understand healthcare experiences.

Our research sought to elucidate the factors that generate patient trust or distrust in healthcare capabilities. We focused on cancer treatment and care.

For this study, we collected and analyzed approximately 500 comments on posts that had seen activity on in the largest cancer community on Reddit during May and June 2017.

We found online activity indicating that healthcare providers can sometimes struggle to gain the trust of cancer patients and caregivers. Patients and caregivers sometimes turn to online communities to seek out reassurances and advice from people in similar circumstances, particularly when they have doubts about the information they receive from their doctors. For this reason, digital spaces are especially useful for research conducted in the healthcare industry.

We also found that certain elements affect how much a patient feels they can trust their healthcare provider:

1). Distrust is often produced by discrepancies in diagnosis, ambiguous information, lack of clear treatment paths, multiple sources of conflicting information or difficult interpersonal exchanges with medical practitioners.

2). The types of institutions most likely to generate patient trust in healthcare capabilities include large institutions with good reputations backed by multiple sources that specialize in a patient’s cancer type.

3). Patients also feel more trusting of their providers when they receive second opinions from other doctors or institutions, when they experience a sense of continuity offered by the consistent and cohesive dispersal of information, and when medical practitioners communicate effectively by simplifying medical language without being reductive or sugarcoating prognosis.

This project is not meant to stand as a comprehensive review of cancer experiences and decision making in healthcare, but does serve to demonstrate the foundation of knowledge that can be gained through digital ethnography. As a form of exploratory research, digital ethnography allows us to become familiar with specific groups of people and identify analytical themes of interest that can inform subsequent research.