Social Media & the Delivery of Healthcare Part IV:

There’s not a lot of guidance assisting with HIPAA-compliant social media strategies.

The American Medical Association’s 2011 Policy entitled “Professionalism in the use of Social Media” helps somewhat to highlight issues. The Policy advises physicians to weigh the following fundamental considerations when maintaining an online presence:

(a) Be aware of patient privacy and confidentiality standards required for all environments. Do not post identifiable patient information online.
(b) Use privacy settings to safeguard personal information as much as possible but do not rely upon them. There is no delete button; once content is posted online it is there forever.
(c) Monitor your own internet presence to ensure content is accurate and appropriate. Online actions may not only adversely affect a physician’s reputation and medical career but also undermines public trust in the medical profession.
(d) Professional ethical guidelines apply to internet interactions between physicians and patients to the same extent as in any other context. Appropriate boundaries must be maintained. The simplest way for physicians to maintain those professional boundaries is to maintain separate personal from professional personas/content online.
(e) Physicians have a responsibility to bring inappropriate or unprofessional content posted by colleagues to their attention so that it may be removed. Interestingly, if the content/behavior significantly violates professional norms and the individual does nothing to resolve the situation, physicians are advised to report the matter to appropriate authorities.

The Food & Drug Administration also recently (Dec 2011) issued its Draft Guidance for Industry Responding to Unsolicited Requests for Off-Label Information About Prescription Drugs and Medical Devices, including in particular those encountered electronically through the internet and/or digital media. The FDA recommends that companies respond privately to any person making an unsolicited request, even though the request may be made in a public forum. Companies may include unpublished data in their in their responses in addition to any other relevant published, peer-reviewed journal articles. The FDA also discusses responses to solicited requests for off-label use that would not constitute illegal promotion.

For the full draft guidance visit http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/UCM285145.pdf. The comment period ends March 27, 2012.

In addition, healthcare providers should limit their liability by having clear policies and procedures that are reviewed often, training their staff on their use and implementation and posting signage with respect to particularly relevant policies throughout their facilities. For example, signage should clearly state that picture-taking is not permitted – even if an individual patient may appear to consent – and photos should not be posted on anyone’s Facebook or other social media pages. Take specific patient conversations offline. Regularly monitor and scrub your own social media platforms, taking care not to delete negative comments (unless inappropriate). Invite anyone having negative feedback to a private meeting to discuss the issues and their resolution.

Finally – there’s social connecting and professional connecting. And, as the song goes, “ne’er the twain shall meet.” As previously mentioned, keep your professional and personal pages separate. Use the privacy settings to block your personal site from patients and colleagues. Revisit the privacy settings frequently because the functionality, features and policies change, requiring readjustment on your part. Your reputation is all you have. Dissemination on the internet is uncontrollable and exponential. What took decades to build can be destroyed by a single event or comment. Also, your pages are discoverable so be careful not to post anything that could hurt your position if you are involved in litigation.

One last takeaway – despite all the issues and concerns, the best things about social media are also the ones that make it so damaging – its unbelievable reach, at lightening speeds – and it’s FREE! So be aware of the issues but do not let them keep you from participating in the conversation.

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