Internet forums and negotiation of healthcare knowledge cultures

Purpose: Internet forums are an important arena for information exchange between consumers. Despite healthcare being one of the most accessed information categories on the internet, knowledge of exchange between patients in online communities remains limited. Specifically, little is known about how patients negotiate knowledge in online forums to understand and manage their diseases. This paper aims to illustrate this by presenting data that demonstrate the construction of tacit knowledge within online health communities, and how consumers exercise their "voice" within complex professional services. Design/methodology/approach: This paper reports an exploratory single case study of an online discussion forum for breast cancer sufferers, in which participants discuss their experience with healthcare services and related pharmaceutical products. Textual data were collected and analysed from the forum retrospectively from an 11-month period, entailing contributions from 252 participants. Findings: The paper challenges prevalent managerial and professional perspectives that evaluate online health information in terms of its correspondence with conventional medical information. In the absence of normative assumptions that broadly guide health service encounters, forum participants negotiate their understandings in the context of their personal experience. Practical implications: This novel culture offers potential for developing rich and sometimes more appropriate understandings of health than available from the medical establishment. It discusses how service providers can exploit such opportunities towards improving service provision, facilitating the consumer voice within a complex service. Originality/value: Re-evaluating the value of online forums, the paper identifies the mechanisms through which health consumers co-create knowledge within online communities, and how these mechanisms can inform and complement future service provision.