Teach your physicians, staff proper social media protocol

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Teach your physicians, staff proper social media protocol

Navigating the new world of social media is challenging for many professions, but perhaps none more so than the medical profession, where physicians and other healthcare professionals must balance a tell-all online culture with the HIPAA Privacy Rule's mandate to protect patient privacy.

With their ever-increasing popularity, social media sites such as Facebook and Twitter™ blur the lines between private and professional identities. Physicians must carefully consider their online lives and recognize that they're navigating a public space that can get them into trouble, say two Boston physicians.

Arash Mostaghimi, MD, MPA, and Bradley H. Crotty, MD, physicians at Beth Israel Deaconess Medical Center, offered some recommendations in their "ideas and opinions” piece published April 19, 2011, in the Annals of Internal Medicine.

"Unlike previous advances in communication, such as the telephone and e-mail, the inherent openness of social media and self-publication, combined with improved online searching capabilities, can complicate the separation of professional and private digital personae,” they wrote.


Hospital elevators and social media

The physicians likened social media to hospital elevators, where most organizations now post signs to remind staff not to discuss patients in public settings where conversations can be easily overheard. Details can facilitate identification even when a patient's name is not mentioned.

"Social networks may be considered the new millennium's elevator: a public forum where you have little to no control over who hears what you say, even if the material is not intended for the public,” Mostaghimi and Crotty wrote in the article.

Even if a physician has no intention of doing anything wrong, social media can get doctors into trouble with violations of patient privacy, says Crotty.

A case in point

The Rhode Island Board of Medical Licensure and Discipline found a Westerly Hospital physician guilty of unprofessional conduct after she posted information on Facebook that allowed identification of a patient.

The board disciplined the physician, who had recounted some of her emergency department ­experiences on Facebook, The Providence Journal reported April 18. Noting that the physician did not include ­patient names and did not intend to disclose confidential information, the board nonetheless said the nature of one patient's injuries allowed an unauthorized individual to ascertain the patient's identity.

The physician deleted her account when she learned what had occurred. The board reprimanded her and fined her a $500 administrative fee.

The hospital terminated the physician in 2011, ­revoking her emergency department privileges for ­posting information about the trauma patient online, The Boston Globe reported April 20.

Physicians should assume that all posted materials are public and therefore exercise care to protect themselves and patient privacy, Crotty and Mostaghimi warned in their article.


Educating physicians-and everyone else

In addition to cautioning physicians about maintaining separate personal and professional identities online, hospitals have a role in educating physicians and other staff, says Crotty. He and his colleague urge hospitals and healthcare organizations to develop standards and educational materials to guide physicians.

"We're not suggesting that physicians should be prohibited from using social media sites,” Mostaghimi said in a Beth Israel press release. "Doctors just need to be savvy regarding the content and tone of what they post online. People share information openly using social ­media, but posts intended for one audience may be embarrassing or inappropriate if seen by another.”


How hospitals can help physicians meet social media challenges

Hospitals should develop standards and create ­educational materials to guide physicians in their use of ­social media, say two Boston physicians.

Arash Mostaghimi, MD, MPA, and Bradley H. ­Crotty, MD, physicians at Beth Israel Deaconess Medical Center, offer recommendations to help physicians meet the challenges they face when using social media. Their recommendations first appeared in an April 19, 2011, opinion piece in the Annals of Internal Medicine.

Hospitals can share these recommendations with their physicians, says Crotty. "It's a starting point. We intended this as a frame of reference,” he says.

Physicians can take the following steps to meet these challenges:

  • Manage your professional identity and image. Encourage physicians and all staff members to employ these strategies to protect their professional online identities.
  • Monitor your online presence with electronic ­self-audits. Google yourself or use other search engines to ­conduct regular audits to learn what information others can see. What personal information do you share online? Do your political affiliations or personal photos appear? Do physician rating sites provide your correct name and office address? Who shares your name, and how can that affect how others might mistakenly view you?
  • Maximize online privacy settings for personal profiles and social networking sites. Separate your personal and professional lives online. Maximize the privacy ­settings on your personal Facebook page to control access. ­Carefully consider what information you post. Don't post information that you might later regret. Remember that the Internet is archived. Once something is posted, "it's almost impossible to take back,” says Crotty.
  • Establish online "dual citizenship” with separate ­professional/public and personal/private networking profiles. Physicians can maintain a professional identity online and a private identity among friends and ­family by ­establishing online dual citizenship. Do this by maintaining a separate online profile intended to ­appear among the top results when someone searches ­online for a specific physician. Create a professional home page, post an online curriculum vitae, or use services such as Google Profiles™ (­profiles). This is particularly advantageous for those entering the medical field because new profiles can redirect ­traffic from other Internet content that may no longer be ­under their direct control. Create a professional website, a public Facebook page, or a Twitter™ account ­specifically for work purposes.
  • Create a professional biography for patients and ­others who find you via an online preferential search. ­Physicians who desire an outward, professional ­presence on social networking sites, such as Facebook, can ­create a public persona to better control ­information. This method also obviates the need to accept or ­deny friend requests from patients or others. Alternatively, physicians can use professional social networking sites, such as LinkedIn and Sermo. Hospitals can create physician profiles on their websites. Physician profiles can include office hours, contact information, education, and professional experience.


Use social media in a professional manner

Employ these strategies to encourage physicians and all staff members to conduct themselves in a professional ­manner online:

  • Ensure staff members understand that all posted content must be considered public and permanent. Information on the Internet is archived and often transmitted from one individual to another. This makes it difficult, if not impossible, to remove information.
  • Encourage physicians, nurses, physician extenders, and office staff to exhibit online behavior that mirrors office behavior standards.
  • Educate staff with respect to HIPAA privacy requirements. They must understand that patient privacy extends to the Internet.


Remember that all patients may not have access to ­electronic resources. Not everyone is using social media to ­communicate. Your facility must reach those patients through different media.