Creating social value in online communities through digital activism

Online health communities bring together patients, caregivers, clinicians, researchers, academics and commerce, including the pharmaceutical industry. These digital platforms focus on common interests such as a particular disease, research, therapies or campaigning to influence policy and funding. Research has revealed that online health communities can reduce regional health disparities and health capability gaps while generating social value for community members and their regions. The literature does not explain, however, how these online health communities actually generate social value.

Research being carried out by Dr Petros Chamakiotis, Associate Professor of Management at ESCP Business School, Dr Dimitra Petrakaki, Reader in Information Systems at the University of Sussex Business School, and Prof Niki Panteli, Professor of Digital Business at Royal Holloway University of London, is bridging this knowledge gap. The research team investigates social value creation in online health communities. They explore the types of social value emerging from online health communities and examine both the process leading to social value creation and the mechanisms contributing to it.

MedicineAfrica
The researchers have chosen the MedicineAfrica digital platform as the context for the study. MedicineAfrica is a non-profit organisation delivering online healthcare education to healthcare professionals in post-conflict states. MedicineAfrica digitally enables global health partnerships with the sharing of health education and research within these fragile environments undergoing transition.

Such online initiatives are made up of members who voluntarily contribute their time to improve clinical practice and healthcare delivery. Moreover, these platforms afford the dispersed partners the opportunity for social value creation through knowledge sharing and learning. The researchers observe that despite their benefits, online communities have a high risk of failure, particularly if they cannot attract and retain members.

The richness of information that is being exchanged as well as its emotional essence renders those platforms sites of consolation and socialisation.

MedicineAfrica relies on the voluntary involvement and participation of its members. At the time their study was conducted (2016-2018), there were around 100 UK-based health professionals – clinicians, nurses, midwives, academics, regulators and clinical managers – who freely gave up their time to educate and support healthcare students and workers in post-conflict countries, such as Somaliland and Palestine. MedicineAfrica started off as a digital platform providing medical education. Through its growing activities and membership, it has developed into an impactful online health community advancing the medical field, creating three types of social value: cognitive, professional and epistemic.

Digital health platforms
Digital health platforms bring together technology and healthcare knowledge in order to advance the delivery of healthcare for both patients and service providers. Digital health platforms differ in their purposes, funding and user involvement. Digital platforms such as PatientsLikeMe are of a public nature and are non-profit oriented, others have a for-profit orientation while some form social enterprises. The majority of digital health platforms build on the assumption that information sharing contributes to positive outcomes, such as improving health, empowering patients and enhancing medical innovation and expertise. The research team highlight how “the richness of information that is being exchanged as well as its emotional essence renders those platforms sites of consolation and socialisation”.

Digital health activism
Recently, researchers have examined how the Internet and social media create and enable digital activism. Digital activism involves the use of digital tools such as the Internet, social media and mobile phones, to bring about social and political change. This entails raising public awareness and mobilising individuals to engage in online collective activities that have a real impact in the (offline) world.

The research team explains how digital health activism emerging in online health communities is “intended to challenge and change existing health status quo by building capacity through knowledge sharing and dissemination”. This research is innovative as it explains how digital activism unfolds within healthcare settings as well as how digital activism contributes to the creation of social value.

Research design and methodology
The researchers took an interpretive case study approach with MedicineAfrica to develop an in-depth understanding of social value creation in the online community context. Their study took place between 2016 and 2018 and drew on three data collection methods: interviews, online observations of the interactions on the platform, and review of several documents about MedicineAfrica dated from 2008, including internal documents, peer-reviewed publications and reports. They conducted 20 semi-structured interviews with 17 MedicineAfrica members (including MedicineAfrica’s founder), both employed and volunteers, from different partnerships (with each partnership operating in a specific region, e.g. Somaliland), specialisms (e.g. psychiatry) and functional areas (e.g., tutors, administrators). Their data underwent interpretive qualitative analysis which led to an understanding of the types of social value MedicineAfrica creates and the process by which this is done. These findings led to the development of a research framework which illustrates the relationships between the platform’s characteristics, the emergence of digital health activism, and ultimately the creation of different types of social value.

Creating cognitive, professional and epistemic social value
The analysis revealed the creation of three types of social value: cognitive, professional and epistemic. Cognitive value emerges from knowledge transfer and exchange between the two parties: tutors and tutees. Know-how is usually imparted by the healthcare professionals to the junior and trainee doctors in the receiving regions. Tutees get the opportunity to learn about clinical practices and procedures that they can then adopt into their own healthcare systems.

Healthcare professionals ranging from medical students to clinicians can benefit from the tuition provided by MedicineAfrica. This analysis revealed that professional value is created through the opportunities the platform provides for healthcare professionals’ development at various stages throughout their career. The researchers discovered that the UK-based doctors/tutors also benefited from their participation. Interviewees said that “it was good for their CV” and referred to their voluntary work as “a dual process”, “shared learning” and “two-way education”, emphasising the broader impact in enhancing professional expertise.

Epistemic value describes the enrichment and validation of the medical knowledge base. This knowledge is not intended for immediate clinical use as it is likely to require further testing and validation. For example, MedicineAfrica offers research opportunities on global health which UK-based tutors would be unable to access otherwise.

The analysis revealed the creation of three types of social value: cognitive, professional and epistemic.

Digital activism: a philanthropic, reciprocal and moral activity
The researchers define digital health activism as “an online collective activity oriented towards changing a problematic health status quo through the dissemination and production of health knowledge in order to promote equity, inclusion and fairness”. Based on this, they discovered three emergent forms of digital health activism: philanthropic, moral and reciprocal activity.

The analysis revealed a clear link between the motivation of the UK-based tutors and the philanthropic purposes of their involvement. They viewed joining MedicineAfrica as a way to contribute to a range of social needs, including health-related needs and clinical expertise. They considered it a worthwhile purpose to put their skills to effective use and be involved in activities that make a difference to someone else and have a direct positive impact on other national health systems. The UK-based doctors recognised offering their medical expertise through MedicineAfrica as fulfilling a moral goal and serving the common good. They were motivated by the extreme contrast in terms of the abundance of resources available in developed countries compared with the scarcity of human, financial and cognitive resources in the developing world. In addition, digital activism was a noticeable form of reciprocity, mainly with migrant healthcare workers in the UK participating in MedicineAfrica as tutors to give medical expertise and know-how back to their home countries. These migrant healthcare workers viewed the platform as a way to address some of the health disparities in their home countries.

Social value creation process
The research team describes how this work unpacks a social value creation process through the interplay of three mechanisms: MedicineAfrica’s ability to connect its members whilst enabling collective practices to emerge on the platform, both technically afforded processes. These processes are coupled with its members’ growing commitment, a socially afforded mechanism. The combination of these three mechanisms makes this unique form of digital health activism possible and ultimately leads to the creation of the three types of social value. This research demonstrates that the digital platform’s potential to set up an online collective of like-minded individuals enables the emergence of this form of digital activism and social value creation.

While these findings are context-specific, the research framework can be extended to explore other digital platforms and online communities. Digital activism and the creation of social value extend beyond the healthcare sector. Further research into other types of digital platforms and sectors will therefore enhance our knowledge of the social value that the platform economy can generate.