Email, Cell Phones and Social Media in the Health Care Environment

UVA Health System Therapy Services recognizes that the use of email, cell phones and social media is pervasive in our lives. These resources are often wonderful sources of healthcare information for us and our patients. Hospitals, healthcare systems, and professional organizations all use email, cell phones and social media for such things as emergency notification, consumer education, and customer service activities.

But email, cell phones and social media sites pose a real challenge for health care professionals. The imperative of maintaining privacy and professional boundaries can become blurred when personal and professional communications are not kept separate.

Be aware that:

  • A nursing student at the University of Louisville was expelled for posting her opinions about her patients, gun rights, and abortion on her MySpace page.
  • Two Wisconsin nurses were fired for posting photos of their patient’s

X-ray on Facebook even though the patient’s identity wasn’t revealed.

  • Healthcare workers have had to turn over their login and password information when named in a lawsuit.
  • Anything posted on the Internet is there forever, even if you remove a picture or content from a site.

McBride, D. & Cohen, E. (2009, July). Misuse of social networking may have ethical implications for nurses. ONS Connect, 17.

Email, cell phones and social media at work should be used for professional purposes only. The literature for healthcare professionals on social media strongly recommends dividing your personal and professional interactions on all social media completely. “Following” your professional organization, UVA, or other health care related sites, as well as finding resources for patients, are great uses of social media and the internet at work. Private social media interactions should be done at home, using non-work email addresses or identities, and should make no mention of your clinical life.

We develop attachments to our patients and their families. But “Friending” patients and families, or sharing your email address with them is strongly discouraged.

Cell phones are great tools which improve our communication access. But try to keep your personal and work communications separate. Use your personal cell phone before or after work, or during scheduled breaks. Try to keep your phone on silent or vibrate whenever possible while in the hospital. If you use a cell phone for your work, keep your ring tones subtle and as quiet as possible to avoid disturbing your patients.

Protect Yourself by Following Some Basic Rules

  • Keep personal and professional communications separate at all times. Any work related emails should be sent using your work email account, not your personal or school account.
  • Do not post anything related to your clinical experiences/work on your personal sites. Set all personal sites as “private” or “friends only”.
  • Avoid controversial issues on sites (such as religion and politics) to maintain your objectivity.
  • Google yourself to monitor your on-line reputation.
  • Remember that what’s posted on line is there (somewhere) forever.
  • Never discuss patients, your supervisor, your work day, your employer, or any other topics related to your practice.
  • Make sure you would be comfortable with anything you post being seen by a current or future employer, your future patients, or your family members.

When using your email, cell phone or social media, remember:

  • Don’t betray your patient’s trust
  • Don’t get suspended from your job or your clinical experience
  • Don’t cheat the hospital
  • Don’t think your Facebook posts are private
  • Don’t jeopardize your reputation and/or future employment opportunities
  • Don’t alienate your supervisors or a current/potential employer

When in doubt…

  • If patients want to take your picture, politely decline. You can honestly tell them the organization discourages it.
  • Remember that even if you don’t mention a patient’s name you can still be violating HIPAA.
  • If patients or co-workers try to include you in situations regarding social media you don’t feel comfortable about, tell them so. Go to your supervisor or clinical instructor for advice and support.

Here are a couple of FAQs that might answer some of your questions about email, cell phones and social media at UVA Health System:

“Can I post pictures or discuss my patients if I don’t identify them?”

No. These are violations of HIPAA. Remember that even if you don’t mention a patient by name, you may still be violating HIPAA laws. The Medical Center Policy Manual has several policies that protect the patient’s right to privacy, including “Violations of Privacy” (MC HR Policy 707) and Confidentiality of Patient Information (MCP 0021). These policies can be found through the clinical portal under “Medical Center Policies.”

“But I’ve set my privacy settings, so I shouldn’t have anything to worry about, right?”

Privacy settings protect the user to a certain extent. Always remember that once something is posted on the internet it is there forever, and you can never be completely certain that it won’t show up in a different location in the future.

“My patient wants to “friend” me on Facebook. Is that OK?”

Our legal resources strongly discourage this. Again, keeping the lines divided between professional and personal contacts is important. Patients have a different perspective of you as a professional. The public has a trusting image of therapists that does not mesh with therapists or students complaining about their patients or their clinical experience on social media sites.

“What do I do if my patient’s family wants to take a picture of me?”

Be prepared for this situation and have a kind but firm answer. Something along the lines of: “That is so sweet of you, but the hospital really prefers that we only have our picture taken except for our IDs.” If the family wants to take a picture of their family member while you are working with them, ask that your face and name tag are not in the picture.

“When I’m at home, I can post whatever I want on social media sites, right?”

This is a difficult position to take for students and therapists.Laws about discoverability are evolving. It is possible for a judge to require health care professionals to turn over their password information in court cases. For example, if you are sued by a patient for malpractice, the patient’s attorney may be able to get permission to use any pictures and postings as evidence about your character and behavior. That “fun” picture of you drinking alcohol at a party suddenly takes a sinister turn.

Please remember that as a UVA Clinical Student, you are representing UVA and your profession, even in your private posts. You may be the first image of UVA or your discipline that many people have. Posting about how difficult your patient was today or how bored you are during your clinical experience gives others a negative image of UVA, Therapy Services and you personally.

And, although UVA will not randomly check your private social media sites, your supervisors can report your activity if they find it objectionable or unethical. Your school and your professional organization have ethical standards to uphold as well.

So Protect Yourself and Protect Your Patients. Use email, cell phones and social media judiciously. Keep your personal and professional communications separate.

References:

Medical Center Policy 0021: Confidentiality of Patient Information

Medical Center Policy 0030:The Use of Cameras and other Electronic Devices and Media

Posted 08.23.13