So­cial me­dia and pa­tient privacy

Hos­pi­tals face chal­lenges with so­cial me­dia pol­icy

Modern Healthcare - - FRONT PAGE - Ashok Sel­vam

Staff at South­ern Ohio Med­i­cal Cen­ter have worked hard to make so­cial me­dia a vi­tal part of their ev­ery­day op­er­a­tions. “It took about three years for ev­ery­body, even our CEO, to get a Face­book ac­count and to put in some in­for­ma­tion about them­selves on­line,” says Vicki Noel, vice pres­i­dent of hu­man re­sources/or­ga­ni­za­tion de­vel­op­ment and chief learn­ing of­fi­cer for the 227-bed hospi­tal in Portsmouth.

While it’s con­sid­ered a vic­tory to have more staffers ac­cept LinkedIn, Twit­ter and Face­book as part of the cul­ture at SOMC, con­cerns over the mis­use of so­cial me­dia per­sist like they do at fa­cil­i­ties na­tion­wide. Wor­ries about pa­tient privacy and de­creased em­ployee pro­duc­tiv­ity re­main, but for hos­pi­tals such as SOMC, so­lu­tions are tricky.

“That’s the thing, with all vi­o­la­tions, it’s shades of gray,” Noel says. “There isn’t an ‘it’s al­ways go­ing to be this way.’ ”

Noel re­calls a privacy in­frac­tion in which a proud med­i­cal res­i­dent posted a picture on Face­book of his su­tur­ing tech­nique on a pa­tient. The res­i­dent in­cluded a sum­mary of the pa­tient’s med­i­cal his­tory and his med­i­cal state as he ar­rived in the emer­gency room.

“He was kind of, ‘I’m get­ting good at su­tures,’” Noel says. “Again, I just think the per­son wanted to show off his su­tures—it was a mat­ter-of-fact thing—tak­ing a picture with a cell­phone.”

Noel says the hospi­tal re­ceived a few warn­ings from staffers alert­ing them to the privacy vi­o­la­tion. The res­i­dent was then given a writ­ten warn­ing about the in­frac­tion.

More than 1,200 hos­pi­tals par­tic­i­pate on 4,200 so­cial net­work­ing sites, ac­cord­ing to a re­port re­leased this month by Price­wa­ter­house­Coop­ers, “So­cial me­dia ‘likes’ health­care: From mar­ket­ing to so­cial busi­ness.” Those sites in­clude stal­warts such as Face­book to up­starts such as Pin­ter­est, which jumped from 1.2 mil­lion U.S. users to 11.7 mil­lion over six months. The same study also re­veals the No. 1 so­cial me­dia con­cern for con­sumers is the dis­sem­i­na­tion of their per­sonal in­for­ma­tion on­line.

Use of smart­phones is a ma­jor rea­son why block­ing ac­cess to so­cial me­dia sites at hospi­tal work­sta­tions in hopes of con­trol­ling their em­ploy­ees isn’t an an­swer to that top con­cern, says Dan Gold­man, le­gal coun­sel for the Mayo Clinic, an or­ga­ni­za­tion that is one of the top ad­vo­cates for so­cial me­dia in health­care. The Mayo Clinic Cen­ter for So­cial Me­dia is ded­i­cated to con­nect­ing pa­tients with clin­i­cians and public af­fairs of­fi­cials and serves as a so­cial me­dia learn­ing re­source for other hos­pi­tals.

Ques­tions re­lated to block­ing so­cial me­dia ac­cess are the most pop­u­lar Gold­man hears at the sem­i­nars he hosts, which show ex­ec­u­tives how to nav­i­gate the some­times in­tim­i­dat­ing world of these new tools. Gold­man also co- hosted a we­bi­nar last year ti­tled, “So­cial me­dia and HIPAA are NOT en­e­mies.” About half of hos­pi­tals and other care providers block so­cial me­dia sites, Gold­man says.

Gold­man says that about three years ago, he started im­mers­ing him­self in so­cial me­dia. He now speaks on pan­els giv­ing ad­min­is­tra­tors tips on how to use so­cial me­dia and draft em­ployee guide­lines. He com­pares In­ter­net use to phone use, and says so­cial me­dia should be treated like any other non­work-re­lated ac­tiv­ity.

“I sort of think it’s a lit­tle like the 1920s on whether phones should be used in health­care,” he says. “A lawyer in the 1920s prob­a­bly said there are too many risks about us­ing phones.”

When es­tab­lish­ing guide­lines, hos­pi­tals must make sure they ref­er­ence le­gal is­sues in­clud­ing the Health In­sur­ance Porta­bil­ity and Ac­count­abil­ity Act, says Kasey Sixt, vice pres­i­dent of CKR In­ter­ac­tive, a re­cruit­ment firm based in Camp­bell, Calif. “The goal of your so­cial me­dia pol­icy is to pro­vide clearly de­lin­eated guid­ance and com­pli­ance boundaries, so em­ploy­ees feel com­fort­able com­mu­ni­cat­ing and par­tic­i­pat­ing on the so­cial chan­nels,” she says.

Block­ing ac­cess won’t elim­i­nate em­ployee dis­trac­tions or the po­ten­tial for abuse, be­cause em­ploy­ees bent on not do­ing their work will use a smart­phone or find an­other out­let, Gold­man says. Re­strict­ing ac­cess also won’t stymie privacy in­frac­tions; that only post­pones the in­evitable, he says.

Un­der­stand­ing how em­ploy­ees of dif­fer­ent ages use so­cial me­dia is also im­por­tant, Gold­man adds. He calls those who grow up us­ing the sites “life­cast­ers”—peo­ple who have spent much time broad­cast­ing their ex­pe­ri­ences on­line. Train­ing them about the per­ils of re­veal­ing im­proper in­for­ma­tion on­line is im­por­tant, he adds.

While the su­ture-happy res­i­dent at SOMC re­ceived a warn­ing, an­other in­ci­dent last year re­sulted in a fir­ing when an emer­gency depart­ment staffer dis­closed pa­tient in­for­ma­tion on­line, Noel says. The pa­tient was al­legedly in­volved in a crime, and an em­ployee de­cided to post in­for­ma­tion on Face­book. When ques­tioned by hu­man re­sources of­fi­cials the next day, the worker ad­mit­ted to ac­cess­ing in­for­ma­tion he shouldn’t have and then post­ing it via so­cial me­dia, Noel says. Once again, it seems a so­cial me­dia team wasn’t nec­es­sary to po­lice em­ploy­ees. Mul­ti­ple co-work­ers alerted staff about the in­frac­tions. Noel says em­ploy­ees can of­ten po­lice them­selves be­cause they know when the line of un­ac­cept­able use of the In­ter­net is be­ing crossed.

“It’s tough when we you have to fire some­one,” Noel says. “It’s a tough, tough les­son.”

Re­strict­ing on­line ac­cess at the work­place might have limited value, but it doesn’t af­fect how an em­ployee uses the In­ter­net away from the job. But there are still con­cerns on how much the em­ployee rep­re­sents his work­place when post­ing on­line musings. That’s some­thing the Na­tional La­bor Re­la­tions Board is in­ves­ti­gat­ing, want­ing to en­sure em­ploy­ers can’t hold em­ploy­ees cul­pa­ble for all they do on­line away from the work­place.

The NLRB re­leased its sec­ond so­cial me­dia re­port in Jan­uary, at­tempt­ing to pro­vide fur­ther clar­ity over what ac­tiv­i­ties con­sti­tute grounds for ter­mi­na­tion of em­ploy­ment. The NLRB’s 35-

“We have fed­eral and le­gal obli­ga­tions for the privacy of our pa­tients, and I think we have a moral re­spon­si­bil­ity that even out­weighs the le­gal obli­ga­tions to our pa­tients,” says Poudre Val­ley CEO Ru­lon Stacey, who writes a blog for the sys­tem.

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