As I discussed in my blog post Trust and Digital Trust, I have defined digital trust between institutions as follows:

Digital Trust of Institution B by Institution A is the act of using Institution A’s digital assets and platform to amplify Institution’s B message to the benefit of both.

Note I define trust as an action, not a nondescript “institutional feeling.”

But to assess—and potentially measure institutional—digital trust between institutions, what digital asset or assets should we be using?

I believe the best proxy metric for digital trust in healthcare is an institution’s Twitter platform.

Consider several of these reasons:

  1. Nearly every public and private institution has a Twitter account.
  2. Twitter has a proven digital architecture that allows for simply institutional communication. For example, the retweet is designed for easy amplification of another institution’s content.
  3. It’s likely that other non-healthcare institutions, such as regional newspapers, follow their larger regional healthcare institutions, allowing them to digitally see (and potentially amplify) inter-institutional trust in action.
  4. Highly trusted and content-heavy national government healthcare institutions, such as the CDC ( @cdcgov), use Twitter extensively, giving institutions a rich variety of useful, shareable content
  5. Most state-level Health Departments, which usually have a good handle on the intricacies of regional public health issues, have an active Twitter presence.
  6. Twitter can share different types of content easily, including written statements, photos, and videos.
  7. For the Twitter gatekeeper (usually a mid-level marketing person) there are multiple tools available for organization and scheduling content. For example, creating predefined lists of trusted organizations by subject matter (CoVid, opioid overdose and distracted driving to name a few) is trivial.
  8. Twitter is “light” for institutions to use. There are no extensive software requirements. It’s mobile-friendly and can be managed remotely.
  9. Twitter has solid internal analytics features, allowing for useful metric generation. There are also ample third-party software tools for more advanced metric generation. This means it should be relatively easy to develop customized measures in digital inter-institutional trust. (For example, if, on average, Hospital Y retweets the CDC 1.5 times a day, and Hospital Z retweets the CDC only 0.5 times a day, then it means Hospital Y digitally trusts the CDC more.)
  10. Unlike some of the newer social media platforms—such as Clubhouse and Snapchat, where the rules for corporate engagement are still developing—the institutional and corporate culture surrounding Twitter are well defined.

Now, there are alternatives to Twitter as a digital trust building platform. For example, a healthcare institution could use their website to directly connect and demonstrate trust with other institutions, such as devoting part of their homepage to CDC content, but it’s unlikely an institution’s executives’ perceptions of what the homepage is for will allow for that.

Or a healthcare institution could build digital trust with other institutions using Facebook. However, compared to Twitter, Facebook tends to allow for more public comment. This will require extensive monitoring and engagement. (In this sense, Facebook is not a “light” form of social media). In addition, since many people tend to overshare personal healthcare information on Facebook I believe most healthcare institutions should steer away from making it the essential pillar of their social media platform.

(Other digital platforms such as YouTube and Instagram should also be considered, but they tend to be used less frequently by most healthcare institutions, which will make digital trust amplification more difficult.)

So in summary, most healthcare institutions should use Twitter as their digital platform of choice to build digital trust, and then use information about their Twitter network as a proxy metric for digital trust.