Healthcare Readiness and Response (November 2023)
Author: Claire Regan DNP, CRNP
Affiliation: NewCourtland Center for Transitions and Health, University of Pennsylvania School of Nursing
The growing influence of misinformation and disinformation on health outcomes in the United States is not new but is being brought to the forefront as an urgent issue. In response, Duke University School of Medicine, Duke Clinical & Translational Science Institute, and RTI International, in collaboration with the Coalition for Trust in Health & Science, hosted the National Forum on Best Practices to Address Health Misinformation: Healthcare Readiness and Response. Thought leaders from diverse backgrounds met to formulate a plan to address and mitigate this societal priority. Specifically, participants offered insights into the devastating impact of misinformation and disinformation, highlighted current research being conducted to address these challenges, and offered a platform for collaboration to accelerate solutions.
Opening remarks were offered by representatives from each of the host organizations, with a focus on the lives affected due to the rapid spread of misinformation and the need to collaborate to cultivate science-based solutions. For example, Dr. Mary Klotman, Dean of the Duke University School of Medicine, discussed the importance of connecting with communities through the healthcare workforce. This workforce, she noted, requires additional knowledge and skills related to enhancing trust and communicating accurate scientific information. She spoke about the commitment of scientific leaders and institutions to both understanding the underpinnings of mistrust and distrust and collaborating to develop strategies that contribute to credible science. Dr. Reed Tuckson, co-founder of the Coalition for Trust in Health and Science, spoke about the social responsibilities we all have to the communities in which we work and live. He highlighted how organizations have demonstrated their dedication to the professional values and ethics underlying healthcare, to care for and serve the community, by committing to movements aimed at addressing misinformation.
Speakers then shifted to reviewing methods to elevate credible sources of information and the role of social media. Dr. Helen Burstin, Chief Executive Officer of the Council of Medical Specialty Societies (CMSS), presented the idea of thinking about health information as a social determinant of health. Access to information that informs health choices and impacts health outcomes should be inclusive, equitable, and credible. Dr. Katrine Wallace, Epidemiologist and faculty member at the University of Illinois Chicago, discussed threats to credible information including the public’s reliance on social media outlets as sources of news and science. She spoke about algorithms used by social media platforms to drive engagement, resulting in the amplification of sensational content that contains misinformation. She ended her remarks with a sense of optimism stating that the dynamics of information sharing on social media can be altered by elevating trusted voices and promoting powerful narratives full of accurate information. Dr. Christine Laine, Editor in Chief of Annals of Internal Medicine, concluded the session by highlighting strategies that both health providers and medical journals can pursue to combat health misinformation. Respecting experiential knowledge, being transparent about conflicts of interest, and acknowledging uncertainty were prominent among the opportunities she highlighted.
The development of interventions to prevent and address the spread of misinformation occupied a significant amount of dialogue at the conference. Leaders of academic institutions who had been recipients of grants from the AAMC shared educational programs, toolkits, short videos, and workshops that have been developed to teach healthcare professionals how to effectively communicate science as well as navigate conversations regarding misinformation. Recognition of how sensitive approaching the topic of misinformation can be and the need to educate health professionals through incorporation of training in medical curriculums was a primary outcome of the discussion.
Small group discussions and fireside chats complemented presentations by offering collaboration, reflection, and the addition of personal narratives. Although the small group topics varied greatly, the resulting messages remained similar. All involved in the delivery of health services need to earn trust by being trustworthy. We need to create health ecosystems in which individuals feel they are heard and represented, and break down barriers to accessing credible, accurate sources of information. Dr. Celine Gounder, Clinical Assistant Professor of Medicine and Infectious Diseases at NYU Grossman School of Medicine, shared her personal and courageous story describing the extraordinary human toll of rampant and invasive misinformation following a tragic personal loss, noting we must support each other in acting to address this incredible challenge.
Dr. Robert Califf, Commissioner of Food and Drugs, offered the final fireside chat of the event. He started by noting that the United States has recently experienced the biggest decline in life expectancy in human history, attributed in part by individuals being inundated with misinformation that impacts health decision making. He called on academic institutions to play a bigger role in the movement to address misinformation, as educators of the next generation of healthcare providers and as employers who have the opportunity to communicate with large segments of the community. His strongest message, ‘if you want to be trusted, act trustworthy’, reinforced the need for collaboration, unity, and connecting with individuals and communities.
This National Forum highlighted the commitment there is to improve the health of those we serve, our communities. All individuals have the right to reliable and accurate information. There is an urgent need to develop and refine mechanisms of access. There was an undeniable sense of urgency to respond to misinformation and call for collaboration from all presenters. The bold message that permeated this meeting was that we must be unified, and we must act now.