For some time now, I have been observing how the sign health, within the digital ecosystem, increasingly becomes a “form of life” narrated through images, voices, soundtracks, testimonials, framings, and everyday micro-dramas that come to organize what the public understands as care, competence, risk, trust, and even “hope.” The article I comment on today, “Digital health communication: a semiotic analysis of Instagram Reels on patient experience and identity construction of Mandaya Royal Hospital Puri,” moves precisely within this terrain. It analyzes Instagram Reels from a private Indonesian hospital (Mandaya Royal Hospital Puri) and shows how these short videos operate simultaneously as health communication and as institutional identity construction.

The study, by Angela Navellia Tjiandra (2025), adopts Roland Barthes’ semiotic approach (focused on denotation, connotation, and myth) to unpack three Reels centered on patient experiences. The first features a pregnant woman with pre-eclampsia who undergoes a cesarean section following the ERACS protocol. The second presents a patient recounting his spine surgery (arthrospine) after years of pain and a vascular event. Finally, the third video concerns an Australian patient who travels to Indonesia for benign prostatic hyperplasia therapy. The central point is that all three Reels function as “explanations” of procedures, that is, they stage a sensitive and highly visual narrative of professionalism, empathy, and high technology; in doing so, they stabilize the image of a “modern and humane” hospital (TJIANDRA, 2025).

From a Barthesian perspective, the denotative layer is relatively straightforward: we see faces, beds, equipment, physicians, spoken statements, before/after sequences, and clean, well-organized environments. What truly matters, however, is connotation – that is, the affective grammar that takes hold. Facial expressions (relief, gratitude), “welcoming” colors and lighting, soothing music, editing rhythm, and the very choice of biographical framing (“I was afraid,” “I suffered for years,” “now I can walk again,” “I decided to travel for treatment”) invite the viewer into a preferred reading, one in which technology is not cold but almost a form of operationalized care. We then arrive at “myth” (in Barthes’ sense), understood as the naturalization of values and ideologies. The videos suggest that technoscientific solutions, when hosted by the “right” institution, lead to outcomes of safety, control, and redemption, reinforcing the belief that technical modernity and emotional humanity walk hand in hand (TJIANDRA, 2025; BARTHES, 2009).

At this point, it is worth drawing a cognitive and also philosophical inference. Cognitively, well-crafted Reels as signifiers exploit shortcuts that humans commonly use when deciding under uncertainty. These shortcuts may take the form of personal narratives (which enhance memorability and adherence), social cues (testimony as evidence), affective contagion (emotions that “guide” judgment), and complexity reduction (a highly technical procedure becomes a story with a beginning, middle, and end). This can be highly beneficial for improving understanding and engagement in health, but it can also induce a sense of “lived” evidence that exceeds the status of the individual case. A moving story, in itself, does not equate to clinically generalizable and reliable information, even though, in everyday perception, it often functions as if it did. This opens the door to a blurring of the boundary between the factual and the fictional.

It is precisely here that semiotics offers a kind of “epistemological brake.” The article demonstrates that we are simultaneously dealing with “content” and with a cultural machine of meaning production, in which each sign (music, smiles, close-ups of technology, white coats, premium environments) contributes to the construction of a preferred reading (to trust, to desire, to choose, to approach, etc.). The hospital emerges as a narrative actor endowed with its own ethos – for example, as competent, welcoming, resolutive, and internationally positioned. This has interpretive effects, as it shapes expectations, guides decisions, and interferes with how people imagine care and evaluate services (TJIANDRA, 2025).

There is also an important detail worth highlighting, as the study dialogues with classic models in the field by suggesting that these videos may activate components of the Health Belief Model (perceived risk/severity, benefits, barriers) and approach “narrative medicine” by placing the patient’s account at the center of meaning (TJIANDRA, 2025). I would add, however, another reading that treats Reels as a technology of “presence,” since they compress social signals (image + voice + text + music) and create perceptual proximity amplified by consumption speed—something written communication rarely achieves. Written text adapts to the reader’s temporality and reading rhythm, in addition to its compositional strategies, whereas videographic text imposes its own time. This increases its “pedagogical” power on the one hand and, on the other, amplifies ethical (ir)responsibility.

What, then, are the responsibilities and tensions that the article leaves implicit (even when not explored in depth)? Three seem decisive to me. First, the risk of technologization as myth – the modeling of the “modern” as an automatic synonym for “better” and “more humane,” which may obscure decisive variables such as access, cost, inequality, continuity of care, and therapeutic limits. Second, the aestheticization of suffering and healing, because when patient experience becomes brand language, the boundary between health education and marketing becomes porous. Third, the issue of privacy and consent, given that testimonials are indeed powerful, but mediatized testimonials are also exposures of vulnerability, requiring clear and auditable protocols.

I read (and recommend) this article as a methodological invitation to problematize digital content as cultural texts that organize affects, beliefs, and identities. For those working in science communication, health education, or institutional communication, its contribution is direct: if one seeks public understanding, trust, and engagement, it is not enough to “state what is correct”; it is necessary to understand how meaning is fabricated on the sensitive surface of signs and how this operates in the brain, in culture, and within power relations.

The main lesson of the text, I would argue, is that Instagram Reels, when centered on patient experiences, produce worlds. And in producing worlds, they also produce the ways in which care is imagined, desired, and legitimized (TJIANDRA, 2025). Thus, although grounded in semiotic analysis, the article reinforces key issues for health education, science communication, and related fields within the sphere of the imaginary – a domain that is too often left untouched in terms of epistemological density – while pointing to valuable research approaches that still need to be further developed.

Glaucio Aranha

References

BARTHES, Roland. Mythologies. New York: Hill and Wang, 2009.

BARTHES, Roland. Elements of Semiology. New York: Hill and Wang, 2006.

CHARON, Rita. Narrative medicine: a model for empathy, reflection, profession, and trust. JAMA, Chicago, v. 286, n. 15, p. 1897–1902, 2001. DOI: 10.1001/jama.286.15.1897.

TJIANDRA, Angela Navellia. Digital health communication: a semiotic analysis of Instagram Reels on patient experience and identity construction of Mandaya Royal Hospital Puri. EPRA International Journal of Multidisciplinary Research (IJMR), v. 11, n. 8, p. 634–642, 2025. DOI: 10.36713/epra23803.

About the author

Glaucio Aranha is a university professor and researcher at the Federal University of Rio de Janeiro (UFRJ), working in neuroscience, science and health education, communication and media studies, science communication, semiotics, and studies of the relationships between mind, brain, and education. He coordinates teaching and science communication initiatives linked to UFRJ and is dedicated to the critical analysis of contemporary forms of meaning production about science and care in the digital ecosystem.

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