“Information Cocoon Room” in Health Communication

Author: Yaxuan Fang

Southern Medical University, JBI Evidence Based Nursing and Midwifery PR China, Guangzhou, China

Introduction

As World Evidence-Based Healthcare Day approaches, it is important to consider ways of communicating effectively with patients. To optimise patient health outcomes,  healthcare professionals need to understand how changing communication methods could enhance patients’ understanding of evidence-based medicine.

Background

I have been studying both nursing science and communication science as part of my bachelor’s degree. In communication science, there are several concepts that I would like to discuss in this blog: ​

Communication chain refers to the pathway or process through which information, influence or pathogens move from a source to a recipient, often involving multiple intermediaries or steps.

Opinion leader ​​ is an individual or entity within a group or society who possesses significant influence over the attitudes, beliefs and behaviours of others due to their expertise, credibility or social status. 

Information cocoon  is a concept in communication and media studies that describes a situation where individuals are increasingly exposed only to information that aligns with their existing beliefs, interests or preferences, while being shielded from dissenting or diverse viewpoints. 

Intelligent distribution in media  refers to the application of artificial intelligence (AI), big data analytics and algorithms to optimise the delivery of content to the right audience, at the right time, through the right channels. This approach enhances the targeting, personalisation and efficiency of media content, which is distributed and consumed based on audiences’ preferences.

Traditionally in the healthcare context, healthcare professionals are the key opinion leaders, with health information pathways going from doctors or nurses to patients. Family members, friends and other people can also influence health information received by patients. However, this relies on people-to-people communication, and the reliability of information can be easily judged. The pathways of communication change considerably, however, when intelligent distribution dominates the content disseminated through internet media.

The problem

In the real-life context, the threshold of healthcare professional-to-patient communication is high and the time and frequency cannot be guaranteed. Most patients’ original knowledge about health and disease cannot be completely changed through a few medical visits; and so, the internet has become a universal way of obtaining health information. However, searching for health information on a vast platform dominated by algorithm recommendations may only increase the ‘information cocoon’ effect. For example, if a person searches for ​​‘Chikungunya fever’​​ once on a media app, the algorithm will ‘think’ that the person wants relevant information on this topic. Therefore, it will continue sending this type of information to the person every time they open app. If the person believes that fever and rash are symptoms of Chikungunya fever and they as Open AI whether they have Chikungunya fever, the Open AI which is linked to the media app will send information, videos, and tips that confirm the person’s belief. Therefore, that person may believe they have  Chikungunya fever, even though their ‘diagnosis’ is made without professional medical knowledge. Indeed, even if they are subsequently diagnosed with another condition by a professional healthcare specialist, they may continue with their original belief. 

This problem is magnified by the patient’s ability to write instructions to Open AI to find suggestions. Different instructions, different knowledge bases and different solutions provided by Open AI software may all result in different treatment suggestions. When the ‘information cocoon’ of patients is ‘correct’, the patient’s self-health knowledge and skills can be enhanced. However, when it is ‘incorrect’, the patient’s ‘information cocoon’ is reinforced, and the more difficult it is for them to believe a real health professional.

The search for answers

This problem has not been well explored in the health science literature, but in communication science, we can propose possible solutions:

• Move the communication chain and opinion leader from the real world to the online community, to enhance reliable information.
• Lower the threshold of healthcare professional-to-patient communication by using online communication.
• Provide diverse forms of information to break down information homogenisation.
• Clearly specify the indications and contraindications when providing health information.
• Improve patients’ awareness of the ‘information cocoon’ and their ability to judge reliable information.
• Develop patient opinion leaders in the online patient community.
• Establish evidence-based information platforms for patients.

Numerous medical professionals have become aware of this problem, and have consequently focused their attention on building reliable online resources for patients. Some healthcare professionals—often those who are well-known opinion leaders in the real world—set up their own accounts on social media to answer people’s questions. By using video, images or live broadcasting, they lower the threshold for healthcare professional-to-patient communication. Some professionals work with social media companies to develop Doctor Open AI app (usually by inputting medical knowledge and evidence to let AI learn from the information). This allows AI to correctly address people’s health concerns. It does this by, for example, asking for symptoms to guide people without professional medical knowledge step-by-step.

Result/outcome

If we adopt the possible solutions outlined above, we may expect to:

• Improve patients’ understanding of medical services.
• Enhance compliance with medical treatment.
• Improve the effects of evidence-based healthcare.

Challenges/obstacles/lessons learned

Doctor-patient and nurse-patient communication methods have changed. Often, patients feel they ‘know better’ based on information they have gained on the internet. When providing evidence-based care for patients, professionalism, trust and compliance are important factors to ensure optimal outcomes. 

New media technologies, including Open AI or video social software, can play a crucial role in the communication chain; however, the reliability of opinion leaders cannot be ensured. People should be vigilant that not all media and Open AI can correctly answer health concerns; this is because it relies on background knowledge and algorithms that may not be evidence-based.

Healthcare workers should lower the threshold of communication and use new communication media to share evidence-based health information. Researchers in the field of evidence-based medicine and evidence-based nursing should deconstruct professional information to allow people without a medical background to learn from the best evidence. Individual doctors and nurses can also become online opinion leaders, thereby broadening their reach through social media.

References

Zhao, Y.Z., & Xiang, T.T. (2024). The ‘information cocoon room’ in health communication and the media value of online health community. Journalism Evolution, 04, 42-51. DOI:CNKI:SUN:XWCQ.0.2024-04-005.

Feng, M.Z., Weng, Y.J., & Cai, T.T., et al. (2025). Conceptual analysis and implications of patient-type opinion leaders. Chinese Health Quality Management,  32(06), 56-61. DOI:10.13912/j.cnki.chqm.2025.32.6.12.

To link to this article - DOI: https://doi.org/10.70253/YNUO8721 

Disclaimer
The views expressed in this World EBHC Day Blog, as well as any errors or omissions, are the sole responsibility of the author and do not represent the views of the World EBHC Day Steering Committee, Official Partners or Sponsors; nor does it imply endorsement by the aforementioned parties.