Individuals and organizations have embraced the use of social media as a way to quickly and easily create and disseminate information, ideas, and experiences, using low-cost, web-based technology. Doctors and others in the healthcare industry have been among those utilizing these new tools, but this use is not undertaken without some concern regarding matters of patient privacy and the blurring the lines between physicians’ public and private personas.
Robert L. Coffield and Joanne E. Joiner report that to date there are at least 540 hospitals in the United States using social media tools to communicate to a general audience. This figure includes 247 YouTube channels, 316 Facebook pages, 419 Twitter accounts, and 67 blogs, and these numbers continue to grow. Further research indicates that though nine out of ten U.S. hospitals are utilizing social media in some way, only one third have a formal social networking plan in place.
Twitter, which has an estimated 6 million monthly visitors, was ranked by Neilson.com in March 2008 as the fastest-growing site in the Member Communities category for the previous month. Among the physicians using social media, particularly Twitter, to connect with patients and colleagues, are a number of “celebrity doctors,” some of whom have more than 75,000 followers. In addition to these practicing physicians, social media and social networking websites are particularly popular among medical students, residents, and interns.
Researchers from the University of Florida’s colleges of Education and Medicine 2008 conducted a survey of the Facebook profiles of medical students and residents. Over 800 medical students’ names were searched on Facebook, and 44 percent of them were found to have profiles. Of these 362, only 37 percent had restricted the level of access to information contained on their profile by altering privacy settings. Additionally, a recent survey of medical school deans indicates that medical students have been found to frequently post inappropriate material on social networking websites.The findings, published in the Journal of the American Medical Association, show that 60 percent of the 80 deans who responded to the survey knew of incidents of unprofessional conduct, and 13 percent admitted to incidents that violated patient privacy.
David H. Brendel, MD, PhD, chair of McLean Hospital’s Institutional Review Board, has similar concerns for medical students’ disregard for protecting patient privacy when posting information on social networking websites. In Dr. Brendel’s case, this concern extends also to practicing physicians using Facebook and other sites, and he advises the following four guidelines for doctors when using online networking websites:
- Address a patient’s online invitation immediately and in person to avoid damaging the therapeutic relationship.
- Do not include information obtained through social networking websites to a patient’s medical record without their consent.
- Use discretion when posting personal information online.
- Understand the privacy policies available on social networking websites and use them to limit access to personal information.
Some healthcare providers chose to connect with patients not only through social networking websites, but also to exchange emails. Results of a 2009 study by Manhattan Research indicated that five percent of approximately 9,000 U.S. adults who participated had send or received an email from a doctor, and 49 percent wanted to do so in the future. Additional data from Manhattan Research included in a report entitled indicate that experts in “Physicians in 2012: The Outlook on Health Information Technology,”five specialties are most likely to contact their patients via email or online messaging: dermatology, medical oncology, neurology, endrocrinology, and infectious disease.
Many physicians are still reluctant to employ the use of email or social media to connect with patients because of privacy risks, despite the potential for beneficial physician and patient interaction. According to Robert L. Coffield and Joanne E. Joiner, even physician-to-physician contact through social networking websites can be problematic if the individuals involved are not careful to ensure that patient information and identifiers are not shared. To prevent some of these issues, telemedicine programs are sometimes utilized. Telemedicine is defined by Merriam-Webster’s dictionary as “the practice of medicine when the doctor and patient are widely separated using two-way voice and visual communication (as by satellite or computer).” It has grown since its first inception to include not only physician-to-patient contact, but also physician-to-physician Unlike standard, “public” social networking websites, iCons in Medicine is medical social networking and telemedicine website which allows doctors to request and send teleconsultations on difficult cases. To ensure patient privacy, iCons in Medicine relies on secure connections and one-on-one sharing of patient data.
Physicians who would like to provide or request teleconsultations can register online to take part in the program. Non-physician individuals with an interest in healthcare can also sign up to participate in the iCons in Medicine network as General Members.