A growing number of physicians are using social media as a professional platform for health communication. Social media can benefit physicians both as sources of content and as platforms for the dissemination of content. There are many benefits to social media, but patient privacy, professionalism, and understanding the challenges and pitfalls of social media must be addressed.
COMMUNICATION AND PROFESSIONALISM
The use of media platforms by physicians and patients has become more popular in the past five years. Although there are many benefits to using social platforms, there also are challenges when physicians use social media. The term social media refers to “electronic communication” in which physician users are able to educate, communicate, and network.1 What is the best way to use social media, and what are its benefits and risks? Do the benefits outweigh the risks? We believe the answer is yes, if you use social media correctly. Social media has been proven to be beneficial but also damaging to society. This is a balance that has to be carefully monitored and regulated so media are not used in the wrong way. Unfortunately, with social media use, there are frequent violations of HIPAA protections regarding patient information. HIPAA defines industry-wide standards for managing and protecting patients’ healthcare information as it pertains to data management, electronic billing, and other processes. The use of social media by physicians can carry the risk of potential HIPAA violations regarding patient confidentiality, privacy, respect, and other protected health information (PHI).
Physicians and patients benefit from proper security protocols and professionalism.
Recent studies have shown that physicians commonly use blogs, Twitter, and other multimedia platforms for sources of information and as a means to communicate. A recent survey suggested most physicians use Twitter because it allows them to receive updated information efficiently.2 Blogs are used by physicians primarily for case studies, discussions, sharing new treatments, and literature summaries. However, there are challenges concerning HIPAA and PHI involving case studies due to their potential inadvertent exposure of sensitive patient information. The average data breach costs a covered entity, on average, $8.19 million, or $420 dollars for every stolen or breached record.3 A data breach could include misplaced data taken home or left in the office in an unsecure location. It also could result because a computer or other electronic devices were left unsecured or with improper security protocols in place. Physicians and patients benefit from proper security protocols and professionalism.
Physicians report that an advantage of social media is its ability to strengthen discussion and data transfer, because it usually takes place in real-time with little delay. New healthcare networking is emerging that will optimize and protect patient–physician communications. During the COVID-19 pandemic, the use of social media has been the most efficient and prudent way for physicians to provide healthcare to many patients considering the limitations on physician–patient contact. Technological advantages of using media platforms include providing care for a greater number of patients with a more time efficient manner. However, care may be limited due to the uncertainty of patient access to necessary technology such as WiFi or camera-enabled devices. Social media platforms make it possible for physicians to stay connected with their colleagues; share knowledge, networking, branding, and benchmarking; and engage in medical education. Using social media offers new ways for physicians to provide healthcare successfully. Physicians are able to collaborate and consult each other about cases and diagnostic difficulties on social media.1 However, there are risks that must be avoided to ensure HIPAA is not violated. Physicians must be cognizant that there can be false information on social media, so they can correct and inform their patients. Statistics show that “nearly 60% of patients report that health care organizations’ social media presence strongly influences where they go for care.”2 In addition to patients receiving educational information on social media, physicians can also benefit by having timely access to up-to-date medical information. Social media allows physicians to receive notifications and updates from health institutions.
Given the growth in social media influence, physicians should advocate for a stronger social media platform that facilitates the growth in clientele. Social media minimizes previous barriers to healthcare for poor and rural populations and ensures greater access to care. It allows for a reduction in cost for patients while they still receive quality care. Although social media care has its benefits, however, personal interactions between the patient and physician will always be the most desirable form of treatment.
It is imperative to understand the risks of social media to avoid pitfalls. Jeopardizing patient confidentiality is one of the most serious risks that can be incurred when using social media platforms. Violations of HIPAA expose patient information that should have remained confidential, and this exposure can result in multiple lawsuits, affecting the malpractice insurance of the organization. Physicians also must be mindful of the information they post, taking care not to post anything that could damage their colleagues, patients, or organizations.
Social media can influence the current or future employment of physicians. “More than 70% of employers currently search networking sites before hiring applicants.”1 It is suggested that physicians not use personal social media accounts because these can increase the risk of damage to reputation and potential exposure of patient information. Personal social media accounts could potentially cause unwanted tagged photos, patient/friend requests, and misunderstood comments and posts. Most patients do not want to see their physicians’ social life online. Because patient information could conceivably be sent to the wrong person unintentionally over email, text, or other platforms, it is crucial to understand the risks and how to properly use social media to ensure compliance with HIPAA.
Pictures of patients have an inadvertent risk of exposing patient information. The most common violations of social media use reported are “inappropriate patient communication online, e.g., sexual misconduct; use of internet for inappropriate practice, e.g., internet prescribing without an established clinical relationship; and online misrepresentation of credentials.’”4 Interestingly, most Boards have indicated these violations are reported to them by patients or their families, as well as other physicians. In response to these violations, 71% of Boards held disciplinary actions.4 Posts on blogs regarding case studies and discussions pose a risk of exposing patient identification. Lack of trust from patients on social media is a challenge that physicians face because of the presence of questionable privacy, false information relating to knowledge and practice.
If a physician chooses to have a personal account, it is critical to use different passwords from those you use for your professional accounts to avoid posting on the wrong platform. This will help protect patient information. Avoid commenting online without the patient’s consent or authorization to do so. Take into account that patient consent must be obtained on paper —otherwise there is potential violation of HIPAA.5 Maintaining confidentiality is the highest priority on social media. This can be done by viewing social media as part of your everyday professional communication. You should act professional and adhere to the same patient privacy principles and codes of conduct on social media as you do in your physical workplace. Although there are no FDA guidelines that regulate healthcare social media, the American Medical Association offers guidelines for social media use from a medical standpoint.
It is important to consider any potential risk to your reputation before posting online, to avoid violations. Physicians must not include patients’ names, pictures, insurance information, or date of birth when participating on social media, even for collaboration on case studies or consults, to ensure that patient information is protected. It is critical to use or build a framework to establish and maintain online professionalism by achieving social media competence, building a positive reputation, ensuring that you post responsibly, and devising ways to keep patient privacy the priority in social media posts, conversation, and information shared with others.6 Social media use that is both ethical and accountable will create a successful relationship. Awareness of accounts, posts, and policies of your workplace institution is critical to avoid any violations.
Social media use is increasing among physicians due to the availability of widespread technology that is now easily accessed by the vast majority of patients. Many protocols are available for physicians to follow for successful use of social media, to minimize the risks of HIPAA violations and the potential of social media to damage reputations. There is a comfort that the patient receives when information online is efficiently transferred and factually stated by physicians. “Surveys show that more than 60 percent of US physicians use a form of media to look for medical information and/or communicate with peers and patients.”2 Social media is growing by leaps and bounds, with more physicians and institutions using these platforms to administer healthcare, especially during the COVID-19 pandemic, as well as integrated in most EHR systems. Therefore, it is imperative that physicians understand and avoid the many risks associated with social media platforms while enjoying the many benefits.
Social media use is growing steadily, and physicians must understand the risks and avoid the possible violations to achieve success.
KEY TAKE-HOME POINTS
- Risks of social media use: violating HIPAA; including patient information on social media without consent; active personal accounts; online patient contact; false information; employment; and professional reputation.
- Benefits of social media use: networking; education; benchmarking; collaborating and communication; increased patient care; time efficiency.
- Ways to avoid pitfalls: awareness of HIPAA and PHI; adhering to workplace policies; digital professionalism; avoidance of personal accounts; password protections; and ensuring accountability.
Juliana VanAlstine. Senior, Georgia College and State University; Milledgeville, Georgia and Janis Coffin, DO, FAAFP, FACMPE, Chief Transformation Officer, Medical College of Georgia/Augusta University Health, Augusta, Georgia.
- Chauhan B, George RS, Coffin JS. Social media and you: what every physician needs to know. J Med Pract Manage. 2012;28:206-209.
- Panahi S, Watson J, Partridge H. Social media and physicians: exploring the benefits and challenges. Health Informatics J. 2016;22(2):99-112. doi:10.1177/1460458214540907. Epub 2014 Jul 18.
- Edwards A. Reaping benefits (and avoiding pitfalls) of social media. AAFP News Blogs. July 10, 2019. www.aafp.org/news/blogs/freshperspectives/entry/20190710fp-socialmedia.html. Accessed October 2020.
- Greysen SR, Chretien KC, Kind T, Young A, Gross CP. Physician violations of online professionalism and disciplinary actions: a national survey of state medical boards. JAMA. 2012;307(11):1141-11422. doi: 10.1001/jama.2012.330.
- Smith JN, Coffin J. Social media, physicians, and points to consider. Podiatry Management. 2018;April/May:91-94. http://images3.podiatrym.com/pdf/2018/4/SmithCoffin418web.pdf. Accessed October 2020.
- Sultan M, Brown EM, Thomas RH. Clinicians embracing social media: potential and pitfalls. Epilepsy Behav. 2021 Feb;115:106462. doi: 10.1016/j.yebeh.2019.106462. Epub 2019 Nov 12.
This article appeared in the July/August 2021 issue of The Journal of Medical Practice Management.