Question

CASE 101

Social Networks and Medicine

Kevin D. Zeiler

The Riverbend Hospital, a hospital located in a rural area of the state, recently purchased laptops for all employees of the hospital system, as well as emergency responders. The goal of the purchase was to streamline medical treatment and information in real time so that patients could receive more timely care. The program has been in place for just over three months with most of the employees feeling that the new system has been a real time-saver. However, a recent leak of patient information has put the program in jeopardy. Because the laptops are provided with Internet access, many of the hospital’s employees have been using them for personal web browsing, social network updating, etc. Ambulance crews have been uploading photos from crash sites, shootings, etc., so that physicians and nurses can be made aware of the mechanism of injury and such. However, an employee in the system recently posted some of those photos to a social network site that many members of the local community share, and it has brought to light an abusive relationship that is taking place in the small community. The photos clearly show the patient and most, if not all, citizens in the small community know her. Furthermore, other providers have started to post comments about her treatment, follow-up care, and other medical conditions. The female patient is currently seeking legal advice and the future of the hospital’s new computer system has been compromised.

Discussion Questions:

1. You are the director of the electronic record delivery program at riverbend and want to see the program continue. However, given the above circumstances, what Act must you rely on to guide you in this process? What does this Act say about the use of electronic medical information?
2. What legal options does the patient have as it pertains to this case?
3. If the program does survive, what can you do as the director to ensure that something like this does not happen again?

BACKGORUND STATEMENT -

MAJOR PROBLEMS AND SECONDARY ISSUES -

YOUR ROLE -

ORGANIZATIONAL STRENGTHS AND WEAKNESS -

Organizational strength:

Organizational weakness:

ALTERNATIVES AND RECOMMENDED SOLUTIONS -

EVALUATION -

Answer 1

Major problems & Secondary Issues :

The number of social network users is rising meteorically, a trend that also includes health-care workers. Even though social networking can serve educational functions and is an effective means of communicating medical resources, it is associated with a variety of important challenges. Misuse of social networks by health-care workers can have dire consequences, ranging from seemingly simple issues such as affecting the doctor's reputation to serious legal matters. Maintaining professionalism and preserving the concepts of confidentiality and privacy is essential. In this review we will analyze some of the dilemmas that have been brought about by the use of social networks in the healthcare environment, as well as existing guidelines on the matter.

The use of electronic information tools, including the use of social networks (SNs), have led doctors to reconsider how to apply the code of ethics that govern the doctor–patient relationship and maintain their professional behavior. Even though these mediums present interesting possibilities of beneficial interactions, they also bring with them different ethical and professional dilemmas. Some of the main challenges we face when using these technologies are the preservation of confidentiality and privacy and maintaining the boundaries of the doctor–patient relationship, as well as reducing the possibility of making public information which may be unprofessional, improper and even illegal.

Organizational Strengths :

1. The use of electronic networks can bring benefits to the institutions in charge of healthcare as well as the patients and the clinicians.
2. The institutions may use them as publicity, customer service, and patient education; on the other hand, the patients can use electronic networks to obtain information, evaluate their progress and receive support.
3. Clinicians can obtain updated information, providing facilities in the research area a fast means of communication between colleagues in order to comment on complicated cases.
4. Nowadays electronic networks are considered a useful tool for medical teaching and practice.Although using it brings benefits like facilitating information to patients, a quick communication channel between the doctor and the patient and the establishment of national and international professional networks.

Organizational Weakness :

1. Loss of confidence in the doctor–patient relationship.
2. Divulgence of the patients’ confidential information, which may be punishable by law.
3. Publication of improper material which brings into doubt the professionalism and prestige of the doctor or institution where one works.
4. Association with false information or fraudulent treatments.

Disappearance of the distinction between professional and social behavior, public and private, in the life of the doctor.

Alternatives & Solutions :

Clinicians should make sure their online profiles reflect standards of professionalism, as well as stress their academic strengths and personal accomplishments. This will certainly raise ethical and legal considerations, concepts like privacy, discrimination and professionalism.

Health institutions have developed disciplinary guidelines with the purpose of ensuring an adequate public image.

Guidelines to follow in the use of social networks. These are collected from different journals published comprising this topic.

• Monitor their online reputation

• Understand the privacy measures of the social network they utilize

• Keep their audience in mind

• Be conscious of the permanency of online content .

• Apply ethical principles to preserve confidentiality, privacy, respect and the doctor–patient relationship

• Keep the professional sphere and the online social sphere separate

• E-mail and other electronic mediums should only be used by doctors in established doctor–patient relationships, and under informed consent

• Periodically review the information available online regarding your person

• Do not make identifiable patient information available online, keeping strict standards of privacy and confidentiality

• Monitor their online presence and use the highest methods of privacy when using a social network

• Be guided by the same ethic professional principles in interactions with patients online as those that apply to any other context

• Separate social and professional online content

• If a doctor finds inappropriate or unprofessional content made available by a colleague, he has the responsibility to bring it to his knowledge so that corrective action can be taken. If it is not taken, or the content violates professional norms, he has the obligation to report it to the correct authorities

• Doctors must be conscious that their actions and content online may affect their own reputations, as well as their patients’, and may affect their careers as well as their credibility as a medical profession.

Conclusions :

It is clear that the popularity of SNs does not seem to be slowing down. It is more and more common for doctors, residents, students and healthcare professionals to interact, one way or another, through electronic media and SNs, whether among themselves or with their patients. This fact has been associated with different ethical, legal and professional difficulties, some of which we have reviewed. However, there are specific guidelines formulated to face these challenges. Moreover, these mediums have opened new ways to improve medical learning and healthcare management. Institutions should adopt or create guidelines which ensure a professional and proper use of SNs, and its training should be a regular part of the curriculum in faculties of medicine. This way, healthcare professionals will be better prepared to face the challenge which we are facing in modern technology era.