Overview: For Milestone Two, you will establish the context for your healthcare product or service, and analyze the market. To establish the context, you will describe the industry segment, describe y

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P T . 2 014 J u l; 3 9(7 ): 4 91-4 99, 5 20. P M CID : P M C4103576

P M ID : 2 5083128

S oc ial M edi a and Heal th Car e P ro fe ssio nals : B enefit s , R is ks, a nd B est P ra ctic e s

C. L ee V ento la

T he a uth or is a c o nsu lt a nt m edic a l w rit e r liv in g in N ew J e rs e y

D is clo su re : T he a uth or r e ports th at s h e h as n o c o m merc ia l o r fin ancia l r e la tio nsh ip s in r e gard to th is a rtic le .

C opyrig ht © 2 014, M ediM edia U SA, In c.

IN TR O DUCTIO N

M an y s o cia l m ed ia t o ols a re a v aila b le f o r h ealth c are p ro fe ssio nals ( H CPs), i n clu din g s o cia l n etw ork in g p la tf o rm s, b lo gs,

m ic ro blo gs, w ik is , m ed ia -s h arin g s ite s, a n d v ir tu al r e ality a n d g am in g e n vir o nm en ts . T hese t o ols c an b e u se d t o i m pro ve o r

en han ce p ro fe ssio nal n etw ork in g a n d e d ucatio n, o rg an iz atio nal p ro m otio n, p atie n t c are , p atie n t e d ucatio n, a n d p ublic h ealth

p ro gra m s. H ow ev er, t h ey a ls o p re se n t p ote n tia l r is k s t o p atie n ts a n d H CPs r e g ard in g t h e d is tr ib utio n o f p oor- q uality

i n fo rm atio n, d am ag e t o p ro fe ssio nal i m ag e, b re ach es o f p atie n t p riv acy, v io la tio n o f p ers o nal– pro fe ssio nal b oundarie s, a n d

lic en sin g o r l e g al i s su es. M an y h ealth c are i n stitu tio ns a n d p ro fe ssio nal o rg an iz atio ns h av e i s su ed g uid elin es t o p re v en t

th ese r is k s.

W HAT A R E S O CIA L M ED IA ?

The d efin itio n o f “ so cia l m ed ia ” i s b ro ad a n d c o nsta n tly e v olv in g. T he t e rm g en era lly r e fe rs t o I n te rn et- b ase d t o ols t h at a llo w

in div id uals a n d c o m munitie s t o g ath er a n d c o m munic ate ; t o s h are i n fo rm atio n, i d eas, p ers o nal m essa g es, i m ag es, a n d o th er

c o nte n t; a n d, i n s o m e c ase s, t o c o lla b ora te w ith o th er u se rs i n r e al t im e. S ocia l m ed ia a re a ls o r e fe rre d t o a s “ W eb 2 .0 ” o r

“so cia l n etw ork in g.”

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Socia l m ed ia s ite s p ro vid e a v arie ty o f f e atu re s t h at s e rv e d if f e re n t p urp ose s f o r t h e i n div id ual u se r. T hey m ay i n clu de b lo gs,

so cia l n etw ork s, v id eo - a n d p hoto -s h arin g s ite s, w ik is , o r a m yria d o f o th er m ed ia , w hic h c an b e g ro uped b y p urp ose , s e rv in g

fu nctio ns s u ch a s:

S ocia l n etw ork in g ( F aceb ook, M yS pace , G oogle P lu s, T w itte r)

P ro fe ssio nal n etw ork in g ( L in ked In )

M ed ia s h arin g ( Y ouT ube, F lic k r)

C onte n t p ro ductio n ( b lo gs [ T um blr , B lo g ger] a n d m ic ro blo gs [ T w itte r])

K now le d ge/in fo rm atio n a g gre g atio n ( W ik ip ed ia )

V ir tu al r e ality a n d g am in g e n vir o nm en ts ( S eco nd L if e )

P artic ip atio n i n s o cia l m ed ia b y t h e g en era l p ublic h as i n cre ase d s h arp ly o ver t h e p ast n in e y ears . I n t h e U .S ., t h e p ro portio n o f

ad ults u sin g s o cia l m ed ia h as i n cre ase d f ro m 8 % t o 7 2% s in ce 2 005. T he u se o f s o cia l m ed ia i s p re v ale n t a cro ss a ll a g es a n d

pro fe ssio ns a n d i s p erv asiv e a ro und t h e w orld . I n 2 012, F aceb ook u se rs e x ceed ed o ne b illio n p eo ple w orld w id e, a n um ber t h at

re p re se n ts o ne-s e v en th o f t h e w orld ’s p o pula tio n. I n a d ditio n, e ach d ay 1 00 m illio n a ctiv e T w itte r u se rs s e n d m ore t h an 6 5

m illio n t w eets , a n d t w o b illio n v id eo s a re v ie w ed o n Y ouT ube. S ocia l m ed ia h av e b een l in ked t o h ig hly s ig nif ic an t p olitic al

e v en ts , s u ch a s t h e A ra b S prin g r e v olu tio n , a s w ell a s t o w id esp re ad s o cie ta l t r e n ds, i n clu din g t h e s h orte n in g o f i n div id uals ’

a tte n tio n s p an s a n d t h e d eclin e o f p rin t n ew s m ed ia .

P A R TIC IP AT IO N IN S O CIA L M ED IA B Y H EALT H C AR E P R O FE SSIO NALS

Socia l m ed ia p ro vid e H CPs w ith t o ols t o s h are i n fo rm atio n, t o d eb ate h ealth c are p olic y a n d p ra ctic e i s su es, t o p ro m ote h ealth

b eh av io rs , t o e n gag e w ith t h e p ublic , a n d t o e d ucate a n d i n te ra ct w ith p atie n ts , c are g iv ers , s tu den ts , a n d c o lle ag ues. H CPs

can u se s o cia l m ed ia t o p ote n tia lly i m pro ve h ealth o utc o m es, d ev elo p a p ro fe ssio nal n etw ork , i n cre ase p ers o nal a w are n ess o f

new s a n d d is c o verie s, m otiv ate p atie n ts , a n d p ro vid e h ealth i n fo rm atio n t o t h e c o m munity .

P hysic ia n s m ost o fte n j o in o nlin e c o m m unitie s w here t h ey c an r e ad n ew s a rtic le s, l is te n t o e x perts , r e se arc h m ed ic al

d ev elo pm en ts , c o nsu lt c o lle ag ues r e g ard in g p atie n t i s su es, a n d n etw ork . T here t h ey c an s h are c ase s a n d i d eas, d is c u ss p ra ctic e

m an ag em en t c h alle n ges, m ak e r e fe rra ls , d is se m in ate t h eir r e se arc h , m ark et t h eir p ra ctic es, o r e n gag e i n h ealth a d vocacy. A

g ro w in g m in ority o f p hysic ia n s a ls o u se s s o cia l m ed ia t o c o m munic ate d ir e ctly w ith p atie n ts t o a u gm en t c lin ic al c are .

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A s u rv ey o f m ore t h an 4 ,0 00 p hysic ia n s c o nducte d b y t h e s o cia l m ed ia s ite Q uan tia M D f o und t h at m ore t h an 9 0% o f p hysic ia n s

use s o m e f o rm o f s o cia l m ed ia f o r p ers o nal a ctiv itie s, w here as o nly 6 5% u se t h ese s ite s f o r p ro fe ssio nal r e aso ns. N early a t h ir d

o f p hysic ia n s h av e r e p orte d p artic ip atin g i n s o cia l n etw ork s. H ow ev er, b oth p ers o nal a n d p ro fe ssio nal u se o f s o cia l m ed ia b y

physic ia n s i s i n cre asin g.

U nlik e p hysic ia n s, p harm acis ts h av e b een r e la tiv ely s lo w t o a d opt s o cia l m ed ia . M uch o f t h e g ro w th i n t h e p ro fe ssio nal u se o f

so cia l m ed ia a m ong t h is g ro up a p pears t o i n volv e p harm acis t- s p ecif ic s o cia l n etw ork s. S urv ey s h av e s h ow n t h at m an y

pharm acis ts u se F aceb ook. A lth ough t h is u se i s m ost o fte n f o r p ers o nal c o m munic atio ns, m ore t h an 9 0 p ag es o n F aceb ook a re

r e la te d t o t h e p harm acy p ro fe ssio n, s u ch a s t h e P harm acis ts I n te re st P ag e, t h e A m eric an P harm acis ts A sso cia tio n, a n d t h e C ynic al

P harm acis t. O nly 1 0% o f p harm acis ts u se T w itte r, a n d a s e arc h f o r “ p harm acis t” o n L in ked In i d en tif ie d 2 74,9 81 p ro file s.

S O CIA L M ED IA S IT E S F O R H EALT H C AR E P R O FE SSIO NALS

S ocia l N etw ork in g S it e s

A s s o cia l n etw ork in g h as e v olv ed , m ed ic ally f o cu se d p ro fe ssio nal c o m munitie s h av e b een e sta b lis h ed . T hese n etw ork s a re o fte n

p riv ate a n d p ro te cte d f ro m n onm em bers , s u ch a s t h e l a y p ublic a n d e v en m em bers o f o th er h ealth p ro fe ssio ns. F undin g s o urc es

fo r t h ese s ite s v ary , w ith f in an cia l s u ppo rt o fte n b ein g p ro vid ed b y p ro fe ssio nal a sso cia tio ns, a d vertis in g o r d ata s a le s, r e se arc h

fu ndin g, a n d p harm aceu tic al c o m pan ie s.

S erm o i s a “ p hysic ia n -o nly ” s o cia l n etw ork in g c o m munity t h at v erif ie s t h e c re d en tia ls o f n ew m em bers d urin g r e g is tr a tio n.

P hysic ia n s r e p re se n tin g 6 8 s p ecia ltie s i n a ll 5 0 s ta te s g ath er o n t h is s ite t o n etw ork , t o d is c u ss t r e atm en t o ptio ns, a n d t o q uery

p eers f o r e x pert a d vic e. A s o f A pril 2 014, S erm o b oaste d a U .S . m em bers h ip o f 2 60,0 00 p hysic ia n s, m ost o f w hom u se

p se u donym s f o r a n onym ity . S erm o c o nsis ts p rim arily o f a l a rg e m essa g e b oard o n w hic h p hysic ia n s c re ate t o pic s f o r d is c u ssio n.

It a ls o p ro vid es a r a tin g s y ste m b y w hic h d octo rs r a n k p osts o n t h e s ite o n t h e b asis o f p erc eiv ed c re d ib ility .

D oxim ity i s a n ew er “ p hysic ia n -o nly ” s o cia l n etw ork in g c o m munity t h at o ff e rs t e x t a n d i m ag es t h at a re c o m plia n t w ith t h e H ealth

I n su ra n ce P orta b ility a n d A cco unta b ility A ct ( H IP A A), w hic h a llo w s p oin t- o f-c are i n fo rm atio n c ro w dso urc in g. A s o f 2 013,

m ore t h an 1 00,0 00 p hysic ia n s a n d s tu den ts w ere m em bers . D oxim ity u se s a n atio nal d ata b ase t o c re ate “ p la ceh old er” a cco unts

w ith d em ogra p hic a n d c o nta ct i n fo rm atio n f o r a ll U .S . p hysic ia n s. T here fo re , a lth ough o nly 1 2% o f U .S . p hysic ia n s a re a ctiv e

m em bers o f D oxim ity , n early 1 00% c an b e m essa g ed t h ro ugh t h e n etw ork .

T he M ed ic al D ir e cto rs F oru m ( w ww.m ed ic ald ir e cto rs fo ru m .s k ip ta .c o m ) i s a s o cia l n etw ork in g s ite f o r m ed ic al d ir e cto rs t h at

p ro vid es a v erif ie d , s e cu re , c lo se d -lo op e n vir o nm en t f o r p eer- to -p eer i n te ra ctio n. T he r e so urc es o n t h is s ite i n clu de a

c o m pre h en siv e l ib ra ry , d is c u ssio n g ro up s, c ale n dar p ostin gs, a n d a le rts . T he s ite a ls o p ro vid es d ed ic ate d g ro up p ag es f o r m ed ic al

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dir e cto rs w ork in g i n a w id e r a n ge o f s e cto rs , i n clu din g: h osp ita l, v ete ra n s a ff a ir s , M ed ic are , g ro up p ra ctic e, e m plo yer, b eh av io ra l

h ealth , m an ag ed c are , c o rre ctio nal f a cility , a n d l o ng-te rm c are .

O th er p hysic ia n n etw ork in g s ite s i n clu de Q uan tia M D ( w ww.q uan tia m d.c o m ), D octo rs ’ H an gout ( w ww.d octo rs h an gout.c o m ), a n d

D oc2 D oc ( d oc2 doc.b m j.c o m ). M an y o f t h ese s ite s r e q uir e d octo rs t o s u bm it t h eir c re d en tia ls t o a s ite g ate k eep er, r e cre atin g t h e

in tim acy o f a “ p hysic ia n s’ l o unge” i n a n o nlin e e n vir o nm en t.

T he n onpro fit S tu den t D octo r N etw ork i s a p opula r s o cia l c o m munity s ite f o r u nderg ra d uate a n d p ra ctic in g p hysic ia n s, d en tis ts ,

a n d v ete rin aria n s i n t h e U .S . a n d C an ad a. I t c la im s m ore t h an 4 0,0 00 a ctiv e m em bers a n d 1 .5 m illio n u niq ue m onth ly v is ito rs .

T he f o ru m s o n S tu den t D octo r N etw ork f o cu s o n c lin ic al c are er t o pic s, d o n ot s u pport d eta ile d u se r p ro file s o r “ frie n din g,” a n d

en co ura g e a n onym ity .

S ocia l n etw ork in g s ite s a re a ls o a v aila b le f o r p harm acis ts . T hese s ite s i n clu de A SH P C onnect ( w ww.c o nnect.a sh p.o rg ) , w hic h i s

s p onso re d b y t h e A m eric an S ocie ty o f H ealth -S yste m P harm acis ts ; P harm QD ( w ww.p harm qd.c o m ); a n d T he P harm acis t S ocie ty

(w ww.p harm acis ts o cie ty .c o m ). P ro fe ssio nal n etw ork in g f o ru m s f o r n urs e s i n clu de t h e A m eric an N urs e s A sso cia tio n’s

A NANurs e S pace ( w ww.a n an urs e sp ace.o rg ) , N urs in gL in k ( w ww.n urs in glin k.c o m ), a n d S ocia lR N ( w ww.t w itte r.c o m /s o cia lR N ).

In a d ditio n, H CPs c an e asily c o nnect w ith e ach o th er v ia “ g en era l p urp ose ” o nlin e s o cia l n etw ork s, s u ch a s F aceb ook, T w itte r, a n d

L in ked In . F aceb ook i s t h e m ost p opula r s o cia l m ed ia s ite i n t h e U .S ., w hile L in ked In i s t h e m ost p opula r p ro fe ssio nal n etw ork in g

site .

B lo gs

T he “ b lo g,” a t e rm f o rm ed b y t r u ncatin g “ W eb l o g,” i s t h e o ld est a n d m ost e sta b lis h ed f o rm o f s o cia l m ed ia , w hic h h as b een u se d

in m ed ic in e s in ce a s e arly a s 2 004. B lo gs c an r e ach w id e a u die n ces, e sp ecia lly i f o ne w rite s c o nte n t t h at i s o f s ig nif ic an t

in te re st. P osts t h at g arn er e n ough i n te re st c an b e s h are d a n d v ie w ed a g ain a n d a g ain b y r e ad ers ( re fe rre d t o a s “ g oin g v ir a l” ).

C onte n t t h at g oes v ir a l c an e sta b lis h a r e p uta tio n o r a n o nlin e p re se n ce.

B lo gs c an a ls o p ro vid e t h e o pportu nity t o p ublis h l a rg e a m ounts o f i n fo rm atio n i n a v arie ty o f m ed ia ( te x t, v id eo , a n d a u dio ) i n a n

o pen f o ru m . M ost b lo ggin g p la tf o rm s a llo w r e ad ers t o r e sp ond t o p ublis h ed c o nte n t b y p ostin g t h eir o w n c o m men ts . T his

e n ab le s a n o ngoin g d ia lo gue b etw een t h e b lo gger a n d h is o r h er a u die n ce. E xam ple s o f w id ely u se d f re e “ lo ng-fo rm ” b lo ggin g

pla tf o rm s i n clu de T um blr ( w ww.t u m blr.c o m ), W ord P re ss ( w ww.w ord pre ss.o rg ) , a n d B lo gger ( w ww.b lo gger.c o m ).

S om e p hysic ia n s u se b lo gs t o c o m munic ate w ith o th er H CPs o r t h e p ublic . F or e x am ple , t h e C lin ic al C ase s b lo g

(w ww.c lin ic alc ase s.o rg ) f e atu re s c ase s tu die s i n a w id e r a n ge o f m ed ic al s p ecia ltie s. T his b lo g a ls o i n clu des a s p ecia l s e ctio n o n

ad m is sio n n ote t e m pla te s, p ro ced ure g uid es, a n d r e la te d m ate ria l. B lo gs a re b eco m in g m ore p opula r a m ong p harm acis ts , b ut

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ap pro xim ate ly t w o-th ir d s o f t h ese b lo gs a re w ritte n a n onym ously .

M ic ro blo gs

M ic ro blo gs p ro vid e t h e m ost d ynam ic a n d c o ncis e f o rm o f i n fo rm atio n e x ch an ge v ia s o cia l m ed ia . T his f o rm at a llo w s u se rs t o

p ost a l a rg e n um ber o f b rie f m essa g es o r u pdate s o ver a s h ort p erio d. N um ero us m ic ro blo ggin g p la tf o rm s e x is t; h ow ev er,

T w itte r i s t h e m ost p ro m in en t. O n T w itte r, u se rs p ublis h m essa g es ( c alle d “ tw eets ” ) t h at c o nsis t o f a m ax im um o f 1 40

ch ara cte rs . T w eets c an b e s u pple m en te d w ith h yperlin ks t o o th er o nlin e m ed ia , s u ch a s v id eo s o r w eb site s. T w eets c an a ls o

in clu de “ h ash ta g s,” a f o rm o f i n fo rm atio n i n dex in g t h at a llo w s p eo ple t o s e arc h f o r t w eets t h at a re r e la te d t o a p artic u la r

d is c u ssio n o r t o pic . H ash ta g s f o llo w ed b y H CPs i n clu de # H CSM ( fo r H ealth C are S ocia l M ed ia ), # M DChat, a n d # H ealth 20.

T here a re m ore t h an 1 40 r e p orte d u se s f o r T w itte r i n h ealth c are . T he P en n S ta te C olle g e o f M ed ic in e h as u se d T w itte r t o

f a cilita te d is c u ssio ns b etw een s tu den ts a n d i n str u cto rs , t o c o nduct c o urs e e v alu atio ns, t o s o lic it c la ss r e sp onse s, a n d t o m onito r

stu den ts ’ p ro gre ss. A T w itte r J o urn al C lu b a ls o p ro vid es a d v an ce p osts a b out p ap ers a n d q uestio ns t o b e d is c u sse d , a lo ng w ith a

h ash ta g , s o t h at s tu den ts , d octo rs , a n d a n yone i n te re ste d i n t h e s u bje ct c an i n te ra ct. T w itte r h as a ls o b een u se d a t m ed ic al

co nfe re n ces t o d is c u ss a n d e n han ce s p eak er p re se n ta tio ns b y p ostin g r e al- tim e c o m men ts f ro m t h e a u die n ce. S om e p hysic ia n s

hav e u se d T w itte r t o d ev elo p a l a rg e f o llo w in g, e n ab lin g t h em t o r e ach a b ro ad a u die n ce a n d p ote n tia lly e v en a ff e ct h ealth p olic y

d ecis io ns.

W ik is

W ik is a re p ublic f o ru m w eb site s f e atu rin g t e x t a n d m ultim ed ia c o nte n t t h at c an b e e d ite d b y u se rs . “ W ik i” i s a H aw aiia n w ord

m ean in g “ q uic k ,” w hic h r e fe rs t o t h e s p ee d w ith w hic h i n fo rm atio n o n a w ik i c an b e a ccesse d , a d ded , e d ite d , o r d ele te d .

S urp ris in gly , W ik ip ed ia i s t h e m ost c o m monly u se d w ik i i n t h e m ed ic al c o m munity . I t i s o fte n u se d a s a r e fe re n ce b y c lin ic ia n s,

d esp ite i ts k now n s h ortc o m in gs, s u ch a s e rro rs a n d n arro w b re ad th o f i n fo rm atio n. O ne s tu dy f o und t h at 3 5% o f 1 ,0 56

pharm acis ts u se d W ik ip ed ia , a lth ough o nly 1 9% t r u ste d i t. I n a n oth er s u rv ey o f m ore t h an 1 ,0 00 p harm acis ts , o ne i n f iv e

re sp onden ts s a id t h ey t r u ste d W ik ip ed ia , b ut o nly o ne i n f o ur k new t h at a n yone c o uld e d it t h e s ite . O ne r e aso n f o r t h e p opula rity

o f W ik ip ed ia i s i ts p ro m in en ce i n G oogle s e arc h es. A s tu dy f o und t h at 7 0% o f 3 5 j u nio r p hy sic ia n s u se d W ik ip ed ia t o f in d

m ed ic al i n fo rm atio n d urin g a w eek -lo ng p erio d, w ith 9 3% c itin g e ase o f u se a s t h eir p rim ary m otiv atio n.

A s t h e a ccu ra cy a n d c o m ple te n ess o f W ik ip ed ia a re o fte n d eb ate d , t h e d ru g i n fo rm atio n o n t h at s ite w as c o m pare d w ith a

v alid ate d a n d t r u ste d i n fo rm atio n s o urc e, t h e M ed sc ap e D ru g R efe re n ce. T his a n aly sis f o und t h at W ik ip ed ia i n clu ded

a p pro xim ate ly 7 6% o f t h e c o nte n t f o und i n M ed sc ap e a n d h ad v ery f e w f a ctu al e rro rs ( m ost w ere e rro rs o f o m is sio n). I n

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co ntr a st, o th er s tu die s h av e f o und t h at W ik ip ed ia i n clu des f a ctu al e rro rs a n d h as a l a ck o f d ep th c o m pare d t o t r a d itio nally e d ite d ,

peer- re v ie w ed , e v id en ce-b ase d i n fo rm atio n s o urc es.

O th er w ik i p ro je cts e m ula te W ik ip ed ia i n t h at t h ey c ro w d-s o urc e m ed ic al c o nte n t. H ow ev er, t o m ain ta in e d ito ria l c re d ib ility , t h ey

a ls o v erif y t h e c re d en tia ls o f c o ntr ib uto rs . R xW ik i ( w ww.r x w ik i.c o m ) a llo w s o nly p harm acis ts t o a d d o r e d it d ru g i n fo rm atio n.

T his w as a ls o t h e m odel f o r M ed ped ia ( a n i n itia tiv e f ro m H arv ard U niv ers ity , S ta n fo rd U niv ers ity , t h e U niv ers ity o f M ic h ig an ,

an d t h e U niv ers ity o f C alif o rn ia a t B erk ele y ), w hic h v erif ie d a u th ors ’ c re d en tia ls b efo re a llo w in g t h em t o g en era te c o nte n t.

H ow ev er, w hen m ost a rtic le s p oste d o n “ au th or v erif ie d ” w ik is w ere c o m pare d w ith o pen i n itia tiv es, s u ch a s W ik ip ed ia , t h ey w ere

f o und t o b e s h orte r, t o b e o f e q ual o r l e sse r q uality , a n d t o i n clu de f e w er r e fe re n ces. W ik ip ed ia w as a ls o f o und t o p ro m ote

q uality a n d a ccu ra cy m ore a ctiv ely o ver a p erio d o f 9 0 d ay s b ecau se o f c ro w dso urc in g, c o m pare d w ith M ed ped ia , w hic h h ad a

c o m para tiv ely r e str ic tiv e e d ito ria l p ro cess.

M edia -S harin g S it e s

M ed ia -s h arin g s ite s, s u ch a s Y ouT ube, o ff e r a l a rg e s e le ctio n o f s o cia l m ed ia t o ols t h at a re o ptim iz ed f o r v ie w in g, s h arin g, a n d

em bed din g d ig ita l m ed ia c o nte n t o n t h e W eb . T hey a ls o p ro vid e f e atu re s t h at a re t y pic ally f o und o n o th er t y pes o f s o cia l m ed ia

s ite s, s u ch a s p ro file s, c o nnectio ns, c o m men ts , a n d p riv ate m essa g in g. M ost m ed ia -s h arin g s ite s a re e asy t o u se , p ro vid e f re e

b asic a cco unts , a n d a re a ccessib le f ro m b oth d esk to p a n d m obile d ev ic es.

In m ed ic in e, m ed ia -s h arin g s ite s c an b e i m porta n t r e so urc es f o r e d ucatio n, c o m munity b uild in g, m ark etin g, a n d b ra n din g.

A m ong t h e m ost n ota b le m ed ia -s h arin g s ite s f o r H CPs i s T he D octo rs ’ C han nel ( w ww.t h ed octo rs c h an nel.c o m ), w hic h h osts

v id eo s f e atu rin g m ed ic al n ew s, c o ntin uin g m ed ic al e d ucatio n, a n d h ealth c are -re la te d e n te rta in m en t.

V ir tu al R ealit y a nd G am in g E nvir o nm en ts

M ulti- U se r V ir tu al E nvir o nm en ts ( M UVEs) a re t h re e-d im en sio nal e n vir o nm en ts t h at a llo w u se rs t o i n te ra ct w ith e ach o th er

th ro ugh a v ir tu al r e p re se n ta tio n o f t h em se lv es ( k now n a s a n a v ata r). T he a p plic atio n o f M UVEs i n h ealth c a re i s g ro w in g

ra p id ly . T hey a re i n cre asin gly b ein g u se d f o r p atie n t e d ucatio n, f o r t h e s im ula tio n o f e p id em io lo gy a n d m ass p ro phyla x is , f o r

psy ch oth era p y, f o r s u rg ery , a n d f o r r e se arc h . H ow ev er, t h e f a ct t h at M UVEs a re o fte n p erc eiv ed a s c o m pute r g am es r a th er t h an

a s s e rio us c lin ic al t o ols m ay i m ped e t h eir a d optio n b y h ealth c are i n stitu tio ns.

M UVEs c an b e c la ssif ie d a s g en era l- p urp ose o r h ealth c are – sp ecif ic . T he m ost w ell- k now n g en era l- p urp ose M UVE i s S eco nd

L if e . T his g en era l- p urp ose e n vir o nm en t, h ow ev er, i s o fte n u se d f o r h ealth c are e d ucatio n. O ne s tu dy f o und 6 8 h ealth -re la te d

v ir tu al l o catio ns o n S eco nd L if e . T hese i n clu ded t h e C en te rs f o r D is e ase C ontr o l a n d P re v en tio n ( C D C) e d ucatio n c en te r, w hic h

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aim s t o i n flu en ce t h e r e al- lif e d ecis io n-m ak in g a b ilitie s o f v is ito rs . H ealth c are – sp ecif ic M UVEs a re t y pic a lly u se d f o r o ne

purp ose , s u ch a s m ed ic al e d ucatio n ( e .g ., C lin iS pace [ w ww.c lin is p ace.c o m ]), s u rg ic al s im ula tio n ( e .g ., O pen S im

[w ww.o pen sim ula to r.o rg ] ), o r p sy ch ia tr ic t r e atm en t ( e .g ., I n W orld S olu tio ns [ w ww.i n w orld so lu tio ns.n et ]).

U SES F O R S O CIA L M ED IA IN H EALT H C AR E

Pro fe ssio nal N etw ork in g

T he m ost p opula r s o cia l m ed ia s ite s f o r p hysic ia n s a re t h ose w here t h ey c an p artic ip ate i n o nlin e c o m munitie s, l is te n t o e x perts ,

a n d n etw ork a n d c o m munic ate w ith c o lle ag ues r e g ard in g p atie n t i s su es. T he u se o f s o cia l m ed ia b y p harm acis ts a ls o f re q uen tly

f o cu se s o n c o m munic atio n w ith c o lle ag ues. T he s o cia l- n etw ork in g p la tf o rm s u se d f o r p ro fe ssio nal n etw ork in g a re o fte n s o le ly

a ccessib le a n d s p ecif ic ally c ate r t o p eo ple w ith in t h ese p ro fe ssio ns. B esid es c lin ic al t o pic s, d is c u ssio ns o n t h ese s ite s a d dre ss

d iv ers e s u bje cts , s u ch a s e th ic s, p olitic s, b io sta tis tic s, p ra ctic e m an ag em en t, c are er s tr a te g ie s, a n d e v en d atin g i n a m ed ic al

e n vir o nm en t. T hey c an a ls o p ro vid e a s u pportiv e e n vir o nm en t f o r H CPs w ho s u bsp ecia liz e.

A noth er e x am ple o f p ro fe ssio nal n etw ork in g a m ong H CPs i s c ro w dso urc in g, w hic h i n volv es h arn essin g t h e k now le d ge a n d s k ills

o f a c o m munity t o s o lv e p ro ble m s o r t o g ath er i n fo rm atio n a n d o pin io ns. S ocia l m ed ia c an a ls o b e u se d t o c o nnect H CPs i n

t h ir d -w orld c o untr ie s w ith s p ecia lis ts i n m ore m ed ic ally a d van ced l o catio ns. F or e x am ple , s u rg ic al p ro ced ure s c an b e s tr e am ed

v ia t h e I n te rn et a n d q uestio ns c an b e a sk ed v ia T w itte r i n r e al t im e. T hus, s o cia l m ed ia p ro vid e a n ew c o m munic atio n c h an nel

fo r H CPs t o n etw ork p ro fe ssio nally t o s h are a n d e x ch an ge m ed ic al i n fo rm atio n i n w ay s a n d a t a p ace t h at w as n ev er b efo re

p ossib le .

P ro fe ssio nal E duca tio n

T he c o m munic atio n c ap ab ilitie s p ro vid ed b y s o cia l m ed ia a re a ls o b ein g u se d t o i m pro ve c lin ic al e d ucatio n. T he h ig h u sa g e r a te

o f s o cia l m ed ia b y 1 8- t o 2 9-y ear- o ld s h as m otiv ate d t h e a d ap ta tio n o f c lin ic al c u rric u la t o r e fle ct t h e c h an gin g h ab its a n d c u ltu re

o f i n co m in g s tu den ts . M an y s tu die s h av e d esc rib ed t h e u se o f s o cia l m ed ia t o ols t o e n han ce c lin ic al s tu den ts ’ u nders ta n din g o f

co m munic atio n, p ro fe ssio nalis m , a n d e th ic s. U niv ers itie s a re a ls o u sin g s o cia l m ed ia t o r e cru it s tu den ts , t o i n cre ase a ccess t o

a cad em ic l ib ra rie s, a n d t o c re ate v ir tu al c la ssro om s a n d o ff ic e h ours , a s w ell a s o th er u niq ue l e arn in g e x perie n ces.

S ocia l m ed ia a re a ls o b ein g w id ely i m ple m en te d i n u nderg ra d uate p harm acy c u rric u la . O ne-th ir d o f p harm acy p ro gra m s h av e

re p orte d u sin g T w itte r i n s o m e c ap acity . A 2 011 s u rv ey a ls o f o und t h at 3 8% o f p h arm acy f a cu lty m em bers u se F aceb ook f o r

te ach in g, w ith h alf r e p ortin g t h at t h ey p la n t o u se s o cia l m ed ia i n t h e f u tu re . I n o ne e x am ple , a n i n str u cto r i n a g eria tr ic

p harm aco th era p y c o urs e a t t h e U niv ers ity o f R hode I s la n d u se d F aceb ook t o e n co ura g e c la ss d is c u ssio ns a n d t o c o nnect s tu den ts

w ith s e n io r c itiz en s w ho h ad v olu nte ere d t o p artic ip ate i n t h e c o urs e . T his e x perie n ce i m pro ved s tu den t p erc e p tio ns o f o ld er

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ad ults a n d a ls o i n tr o duced t h e s e n io r c itiz en s t o F aceb ook. A t A uburn U niv ers ity , i n str u cto rs e sta b lis h ed T w itte r h an dle s s o t h at

p harm acy s tu den ts c o uld p artic ip ate i n c la ss d is c u ssio ns a n onym ously . B y s e m este r’s e n d, 8 1% o f s tu den ts f e lt T w itte r h ad l e t

th em e x pre ss o pin io ns t h ey w ould n’t h av e s h are d o th erw is e , a lth ough 7 1% t h ought t h at T w itte r h ad b een d is tr a ctin g.

O nlin e s o cia l m ed ia p la tf o rm s h av e a ls o i n flu en ced t h e e d ucatio nal e x perie n ce f o r n urs e s, w ith o ne s u rv ey r e p ortin g t h at 5 3% o f

nurs in g s c h ools a re n ow u sin g t h ese t o ols . F or e x am ple , T w itte r h as b een u se d t o e n han ce t h e c lin ic al d ecis io n-m ak in g s k ills o f

nurs in g s tu den ts i n c ritic al c are s itu atio n s. T he s tu den ts v ie w ed v id eo s o f c lin ic al s c en ario s a n d t w eete d t h eir o bse rv atio ns o n t h e

patie n t’s c o nditio n f o r i n str u cto r f e ed bac k . O th er u se s o f T w itte r i n n urs in g e d ucatio n i n clu de p ostin g a l iv e s tr e am o f s tu den t

in sig hts d urin g c la ss, o r c re atin g a c la ss h ash ta g s o t h at r e so urc es s u ch a s v id eo s, w eb site s, a rtic le s, a n d p hoto gra p hs c o uld b e

sh are d . M ed ia s h arin g s ite s s u ch a s Y ouT ube c an a ls o b e u se d i n t h e c la ssro om t o s tim ula te d is c u ssio n, t o i llu str a te a p oin t, o r t o

r e in fo rc e a c o ncep t. S tu den ts c an v ie w a v id eo a n d t h en r e sp ond t o q uestio ns t h at p ro m ote c lin ic al r e aso nin g.

T he i n co rp ora tio n o f s o cia l m ed ia i n to c lin ic al e d ucatio n h as m et w ith m ix ed r e v ie w s, h ow ev er. C ours e s t h at i n co rp ora te s u ch

to ols h av e g en era lly b een p ositiv ely r e ceiv ed , b ut i n s o m e c ase s, s tu den ts h av e r e p orte d f e elin g t h at t h e u se o f F aceb ook f o r

te ach in g p urp ose s i s a n i n tr u sio n i n to t h eir s o cia l l iv es. B ala n cin g t h e e n han ced c o m munic atio n o pportu nitie s p ro vid ed b y s o cia l

m ed ia w ith t h e d ow nsid e o f i n cre ase d d is tr a ctio n i n a n e d ucatio nal e n vir o nm en t i s a ls o a c h alle n ge. U nfo rtu nate ly , s ta n dard s

guid in g t h e a p pro pria te u se o f s o cia l m ed ia t o ols i n e d ucatio n a re i n t h eir i n fa n cy.

O rg aniz a tio nal P ro m otio n

H ealth c are o rg an iz atio ns, i n clu din g h osp ita ls , h ealth s y ste m s, p ro fe ssio nal s o cie tie s, p harm aceu tic al c o m pan ie s, p atie n t a d vocacy

g ro ups, a n d p harm acy b en efit c o m pan ie s, a re u sin g s o cia l m ed ia f o r m an y p urp ose s. U se s i n clu de c o m munic atin g w ith t h e

co m munity a n d p atie n ts ; e n han cin g o rg an iz atio nal v is ib ility ; m ark etin g p ro ducts a n d s e rv ic es; e sta b lis h in g a v en ue f o r a cq uir in g

new s a b out a ctiv itie s, p ro m otio ns, a n d f u nd-ra is in g; p ro vid in g a c h an nel f o r p atie n t r e so urc es a n d e d ucatio n; a n d p ro vid in g

cu sto m er s e rv ic e a n d s u pport. I t h as b een e stim ate d t h at 7 0% o f U .S . h ealth c are o rg an iz atio ns u se s o cia l m ed ia , w ith

F aceb ook, T w itte r, a n d Y ouT ube b ein g t h e m ost p opula r. B lo gs a re a ls o u se d b y m an y m ed ic al c en te rs a n d h osp ita ls .

S tu die s h av e s h ow n t h at t h is u se o f s o cia l m ed ia c an g re atly e n han ce t h e i m ag e a n d v is ib ility o f a m ed ic al c en te r o r h osp ita l. I n

o ne s tu dy, 5 7% o f c o nsu m ers s a id t h at a h osp ita l’s s o cia l m ed ia p re se n ce w ould s tr o ngly i n flu en ce t h eir c h oic e r e g ard in g w here t o

g o f o r s e rv ic es. A s tr o ng s o cia l m ed ia p re se n ce w as a ls o i n te rp re te d b y 8 1% o f c o nsu m ers a s b ein g a n i n dic atio n t h at a h osp ita l

o ff e rs c u ttin g-e d ge t e ch nolo gie s. I n a n oth er s tu dy, 1 2.5 % o f s u rv ey ed h ealth c are o rg an iz atio ns r e p orte d h av in g s u ccessfu lly

a ttr a cte d n ew p atie n ts t h ro ugh t h e u se o f s o cia l m ed ia .

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The r a te o f s o cia l m ed ia a d optio n b y n onp ro fit h ealth c are o rg an iz atio ns i s a ls o i n cre asin g. T he M ay o C lin ic b ecam e a n

in te rn atio nal l e ad er i n s u ch e ff o rts w hen i t e sta b lis h ed t h e S ocia l M ed ia H ealth N etw ork ( h ttp ://s o cia lm ed ia .m ay oclin ic .o rg ) i n

2 010. I n i ts m is sio n s ta te m en t f o r t h e n etw ork , t h e c lin ic s a id i t s o ught t o p ro vid e a n “ au th en tic v oic e f o r p atie n ts a n d h ealth c are

p ro fe ssio nals , b uild in g r e la tio nsh ip s t h ro ugh t h e r e v olu tio nary p ow er o f s o cia l m ed ia .” T o t h at e n d, t h is i n itia tiv e h as c re ate d a

p re se n ce o n F aceb ook, Y ouT ube, a n d T w itte r. I t a ls o p ro vid es a v ast l ib ra ry o f b lo g p osts , p odcasts , c o nfe re n ces, a n d w eb in ars

to e n gag e v ario us c o m munity s ta k eh old ers . T he M ay o C lin ic a n d o th er e d ucatio nal h ealth c are i n stitu tio ns h av e a ls o u se d b lo gs

to f o ste r p eer- to -p eer l e arn in g a n d t o i m ple m en t n ew p ro to co ls . M an y u niv ers itie s a ls o h av e a b ra n ded Y ouT ube c h an nel, w here

v id eo s c an b e s h are d t h ro ugh t h e u niv ers ity ’s s o cia l m ed ia s ite .

S ocia l m ed ia a ls o a llo w p harm acie s t o c o m munic ate w ith l a rg e g ro ups o f c u sto m ers s im ulta n eo usly , t o c o nduct s u rv ey s, a n d t o

e n ab le p atie n ts t o f e el t h at t h ey a re p art o f a p harm acy c o m munity . M an y p harm acie s u se s o cia l m ed ia t o r e ach o ut t o f o llo w ers

a b out p ro ducts , s e rv ic es, d is c o unts , n ew sw orth y e v en ts , a n d h ealth i n fo rm atio n. S ev era l l a rg e p harm acie s a n d i n su re rs h av e

pilo te d p ro gra m s t h at p ro vid e p re sc rip tio n r e fill a n d a p poin tm en t r e m in ders v ia s o cia l- m ed ia t e x t m essa g in g.

P atie nt C are

A lth ough t h ere h as b een a r e lu cta n ce a m ong H CPs t o u se s o cia l m ed ia f o r d ir e ct p atie n t c are , t h is p ra ctic e i s s lo w ly b ein g

accep te d b y c lin ic ia n s a n d h ealth c are f a cilitie s. F or e x am ple , G eo rg ia H ealth S cie n ces U niv ers ity h as p ro vid ed p atie n ts w ith

a ccess t o a p la tf o rm c alle d W eb V ie w , w hic h a llo w s t h e p atie n ts t o r e ach t h eir d octo rs t o a sk q uestio ns o r t o r e q uest p re sc rip tio n

re fills .

R ecen t s tu die s h av e f o und t h at p hysic ia n s h av e b eg un t o d ev elo p a n i n te re st i n i n te ra ctin g w ith p atie n ts o nlin e. S om e p hysic ia n s

are u sin g s o cia l m ed ia , i n clu din g T w itte r a n d F aceb ook, t o e n han ce c o m munic atio n w ith p atie n ts . A ppro xim ate ly 6 0% o f

physic ia n s w ere f o und t o f a v or i n te ra ctin g w ith p atie n ts t h ro ugh s o cia l m ed ia f o r t h e p urp ose o f p ro vid in g p atie n t e d ucatio n a n d

health m onito rin g, a n d f o r e n co ura g in g b eh av io ra l c h an ges a n d d ru g a d here n ce, w ith t h e h ope t h at t h ese e ff o rts w ill l e ad t o “ b ette r

e d ucatio n, i n cre ase d c o m plia n ce, a n d b ette r o utc o m es.” H ow ev er, o th er s tu die s h av e s h ow n t h at c o nsid era b le r e sis ta n ce s till

e x is ts t o u sin g s o cia l m ed ia t o i n te ra ct w ith p atie n ts . I n a s u rv ey o f a p pro xim ate ly 4 80 p ra cti c in g a n d s tu den t p hysic ia n s, 6 8%

fe lt i t w as e th ic ally p ro ble m atic t o i n te ra ct w ith p atie n ts o n s o cia l n etw ork s f o r e ith er p ers o nal o r p ro fe ssio nal r e aso ns.

E vid en ce i n dic ate s t h at e le ctr o nic c o m munic atio n w ith p atie n ts c an i m pro ve t h eir c are a n d h ealth o utc o m es. S tu die s h av e

sh ow n t h at s u pple m en ta l e le ctr o nic c o m munic atio n e m phasiz es p hysic ia n s’ a d vic e a n d i m pro ves a d here n ce f o r p atie n ts w ith

c h ro nic d is e ase s. I t m ay a ls o i m pro ve p atie n t s a tis fa ctio n b y i n cre asin g t h e t im e s p en t c o m munic atin g w ith a n d h av in g

questio ns a n sw ere d b y t h eir p hysic ia n s. A s u rv ey o f p atie n ts a t a n o utp atie n t f a m ily p ra ctic e c lin ic f o und t h at 5 6% w an te d t h eir

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HCPs t o u se s o cia l m ed ia f o r r e m in ders , f o r s c h ed ulin g a p poin tm en ts , f o r d ia g nostic t e st r e su lts , f o r p re sc rip tio n n otif ic atio ns, a n d

fo r a n sw erin g g en era l q uestio ns. P atie n ts w ho d id n ot u se s o cia l m ed ia s a id t h ey w ould s ta rt i f t h ey k new t h ey c o uld c o nnect

w ith t h eir h ealth c are p ro vid er.

P atie nt E duca tio n

Socia l m ed ia c an a ls o i m pro ve p atie n ts ’ a ccess t o h ealth c are i n fo rm atio n a n d o th er e d ucatio nal r e so urc es. I n t h e U .S ., e ig ht i n

1 0 I n te rn et u se rs s e arc h f o r h ealth i n fo rm atio n o nlin e, a n d 7 4% o f t h ese p eo ple u se s o cia l m ed ia . T hro ugh s o cia l m ed ia ,

p atie n ts c an j o in v ir tu al c o m munitie s, p artic ip ate i n r e se arc h , r e ceiv e f in an cia l o r m ora l s u pport, s e t g oals , a n d t r a ck p ers o nal

p ro gre ss.

P hysic ia n s a re a ls o u sin g s o cia l m ed ia t o p ro m ote p atie n t h ealth c are e d ucatio n. T hey t w eet, m ak e b lo g p osts , r e co rd v id eo s, a n d

partic ip ate i n d is e ase -s p ecif ic d is c u ssio n f o ru m s f o cu se d o n p atie n t e d ucatio n. S uch f o ru m s p ro vid e a n i m porta n t o ppo rtu nity

f o r p hysic ia n s t o d is tr ib ute e v id en ce-b ase d i n fo rm atio n t o c o unte r i n accu ra te m ate ria l o n t h e I n te rn et. I n s o m e s o cia l m ed ia

f o ru m s, t h e p ublic i s p ro vid ed w ith a n o pportu nity t o p artic ip ate i n t h ese d is c u ssio ns.

U nlik e o th er h ealth a d vic e t h at a p atie n t m ig ht e n co unte r o nlin e, p hysic ia n s c o uld u se s o cia l m ed ia t o d ev elo p m essa g in g t h at m ay

b e m ore l ik ely t o r e so nate w ith a n d b e a c te d o n b y p atie n ts . S om e p hysic ia n s b elie v e t h at s o cia l m ed ia w ould b e p artic u la rly

b en efic ia l f o r p atie n ts w ith c h ro nic , r a re , o r f a ta l d is e ase s; w ith q uestio ns a b out m ate rn al o r i n fa n t c are ; o r w ith p ers o nal h ealth -

re la te d g oals , s u ch a s w eig ht m an ag em en t. T he d is tr ib utio n o f c re d ib le i n fo rm atio n h as b een p ro ved t o m otiv ate o bse rv ab le

b eh av io ra l c h an ges w ith in s o cia l n etw ork s. R ese arc h h as b eg un t o s h ow t h at i n te rv en tio ns b ase d o n s o cia l m ed ia c an p ositiv ely

a ff e ct w eig ht l o ss, t o bacco c essa tio n, r is k y s e x ual b eh av io rs , a n d p hysic al a ctiv ity .

P atie n ts a re a ls o u sin g s o cia l m ed ia t o c o n nect w ith o th ers a ff e cte d b y s im ila r c o nditio ns. F or e x am ple , t h e s o cia l n etw ork in g s ite

P atie n ts L ik eM e ( w ww.p atie n ts lik em e.c o m ) p ro vid es a v en ue f o r p atie n ts t o a ccess i n fo rm atio n, s u ggestio ns, a n d s u pport f ro m

oth er p eo ple w ho h av e t h e s a m e d is e ase o r c o nditio n. F aceb ook g ro ups a ls o f re q uen tly f o cu s o n s p ecif ic m ed ic al c o nditio ns.

T hese g ro ups a ctiv ely e n gag e i n p eer- to -p eer s u pport a s w ell a s f u nd-ra is in g e ff o rts f o r a ff ilia te d o rg an iz atio ns a n d i n div id uals .

P ublic H ealt h P ro gra m s

Socia l m ed ia h av e c re ate d v ast g lo bal n etw ork s t h at c an q uic k ly s p re ad i n fo rm atio n a n d m obiliz e l a rg e n um bers o f p eo ple t o

f a cilita te g re ate r p ro gre ss t o w ard p ublic h ealth g oals . S ocia l m ed ia c an t h ere fo re b e a p ow erfu l t o ol f o r p ublic e d ucatio n a n d

ad vocacy r e g ard in g p ublic h ealth i s su es. S om e s ta te s’ p ublic h ealth d ep artm en ts a re u sin g T w itte r a n d o th er s o cia l m ed ia f o r

th ese p urp ose s.

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O th er p ublic h ealth o rg an iz atio ns u se k ey w ord c o nte n t f ro m T w itte r a n d o th er s o cia l n etw ork s, i n c o m bin atio n w ith l o catio n-

tr a ck in g t e ch nolo gie s, t o r e sp ond r a p id ly t o d is a ste rs a n d t o m onito r t h e h ealth a n d w elf a re o f p opula tio ns. T he C D C m ain ta in s

an a ctiv e p re se n ce o n T w itte r a n d F aceb o ok t o t r a ck “ tw eets ” t h at m ig ht i n dic ate a f lu o utb re ak a n d t o s h are u pdate s a b out s u ch

in cid en ts . T he C D C h as a ls o u se d s o cia l m ed ia t o l o cate a n d m onito r s o urc es a n d s u sp ecte d c ase s o f L eg io nnair e ’s d is e ase .

O rg an iz atio ns s u ch a s t h e R ed C ro ss t r a ck T w itte r p osts d urin g n atu ra l d is a ste rs , s u ch a s h urric an es a n d e arth quak es, t o g ath er

in fo rm atio n a b out w here t h e g re ate st n eed s a re . C itiz en -re p ort b lo gs h av e a ls o b een m onito re d b y h osp ita ls f o r i n fo rm atio n

ab out p ote n tia l m ass c asu alty e v en ts . W hen u se d i n t h is w ay, r e al- tim e s o cia l m ed ia s ite s p ro vid e g re ate r a g ility a n d e n han ced

p re p are d ness f o r r e sp onse s t o d is a ste rs a n d p ublic h ealth e m erg en cie s. S ocia l m ed ia s ite s a ls o p ro vid e d is a ste r a n d e m erg en cy

re sp onse p ers o nnel w ith a m ean s t o r a p id ly s h are a n d a ccess i m porta n t i n fo rm atio n p ro vid ed b y a g en cie s s u ch a s t h e C D C a n d t h e

U .S . P re v en tiv e S erv ic es T ask F orc e.

T he w id esp re ad u se o f s o cia l m ed ia c an a ls o i n flu en ce p ublic h ealth b eh av io rs a n d g oals t h ro ugh s o cia l r e in fo rc em en t. B ecau se

h um an b ein gs a re a h ig hly s o cia l s p ecie s, t h ey a re o fte n i n flu en ced b y t h eir f rie n ds, a s w ell a s b y f rie n ds o f f rie n ds. O ne e x am ple

o f t h e p ow erfu l e ff e ct o f s o cia l m ed ia w as s e en a fte r F aceb ook d ecid ed t o a llo w u se rs t o p ost t h eir o rg an -d onor s ta tu s i n t h eir

p ro file . A cco rd in g t o D onate L if e A m eric a, t h e w eek a fte r t h is f e atu re w as i n tr o duced , o nlin e s ta te o rg an -d onor r e g is tr ie s

e x perie n ced a 2 3-fo ld s u rg e i n d onor p le d ges t h at w as p re su m ab ly d ue t o t h is s o cia l- n etw ork in g e ff e ct.

T H E D AN G ER S O F S O CIA L M ED IA

P oor Q ualit y o f In fo rm atio n

T he m ain l im ita tio n o f h ealth i n fo rm atio n f o und o n s o cia l m ed ia a n d o th er o nlin e s o urc es i s a l a ck o f q uality a n d r e lia b ility .

A uth ors o f m ed ic al i n fo rm atio n f o und o n s o cia l m ed ia s ite s a re o fte n u nknow n o r a re i d en tif ie d b y l im ite d i n fo rm atio n. I n

a d ditio n, t h e m ed ic al i n fo rm atio n m ay b e u nre fe re n ced , i n co m ple te , o r i n fo rm al. W hile e v id en ce-b ase d m ed ic in e d e-e m phasiz es

a n ecd ota l r e p orts , s o cia l m ed ia t e n d t o e m phasiz e t h em , r e ly in g o n i n div id ual p atie n t s to rie s f o r c o lle ctiv e m ed ic al k now le d ge.

S im ila r p ro ble m s e x is t w ith t r a d itio nal o nlin e m ed ia ; h ow ev er, t h e i n te ra ctiv e n atu re o f s o cia l m ed ia m ag nif ie s t h ese i s su es, s in ce

a n y u se r c an u plo ad c o nte n t t o a s ite . S ocia l m ed ia u se rs m ay a ls o b e v uln era b le t o b oth h id den a n d o vert c o nflic ts o f i n te re st

th at t h ey m ay b e i n cap ab le o f i n te rp re tin g.

M easu re s a re a v aila b le t h at m ay b e u se fu l i n a d dre ssin g t h is p ro ble m . H CPs c an g uid e p atie n ts t o c re d ib le p eer- re v ie w ed w eb site s

w here t h e i n fo rm atio n i s s u bje ct t o q uality c o ntr o l. T he W orld H ealth O rg an iz atio n i s l e ad in g a r e q uest t o t h e I n te rn et

C orp ora tio n f o r A ssig ned N am es a n d N um bers t o e sta b lis h a n ew d om ain s u ff ix t h at w ould b e u se d s o le ly f o r v alid ate d h ealth

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in fo rm atio n. T he i s su an ce o f t h is d om ain s u ff ix w ould b e s tr ic tly r e g ula te d , a n d t h e c o nte n t o f w eb site s w ith t h ese a d dre sse s

w ould b e m onito re d t o a ssu re c o m plia n ce w ith s tr ic t q uality c rite ria . T hese d om ain a d dre sse s w ould b e p rio ritiz ed b y s e arc h

e n gin es w hen p ro vid in g r e su lts i n r e sp onse t o h ealth -re la te d i n quir ie s.

D am age to P ro fe ssio nal Im age

A m ajo r r is k a sso cia te d w ith t h e u se o f s o cia l m ed ia i s t h e p ostin g o f u npro fe ssio nal c o nte n t t h at c an r e fle ct u nfa v ora b ly o n H CPs,

stu den ts , a n d a ff ilia te d i n stitu tio ns. S ocia l m ed ia c o nvey i n fo rm atio n a b out a p ers o n’s p ers o nality , v alu es, a n d p rio ritie s, a n d t h e

fir s t i m pre ssio n g en era te d b y t h is c o nte n t c an b e l a stin g. P erc ep tio ns m ay b e b ase d o n a n y o f t h e i n fo rm atio n f e atu re d i n a s o cia l

m ed ia p ro file , s u ch a s p hoto s, n ic k nam es, p osts , a n d c o m men ts l ik ed o r s h are d , a s w ell a s t h e f rie n ds, c au se s, o rg an iz atio ns,

g am es, a n d m ed ia t h at a p ers o n f o llo w s.

B eh av io r t h at c o uld b e c o nstr u ed a s u npro fe ssio nal i n clu des v io la tio ns o f p atie n t p riv acy ; t h e u se o f p ro fa n ity o r d is c rim in ato ry

la n guag e; i m ag es o f s e x ual s u ggestiv en ess o r i n to xic atio n; a n d n eg ativ e c o m men ts a b out p atie n ts , a n e m plo yer, o r a s c h ool. S uch

p ublic m is ste p s b y H CPs h av e b een d ocu m en te d , i n clu din g p hysic ia n s t a k in g d ig ita l p hoto gra p hs d urin g s u rg ery , p osin g w ith

w eap ons o r a lc o hol, a n d p ostin g “ tw eets ” t h at a re h arm fu l t o a n i n div id ual o r t h e p ro fe ssio n. T he a ir in g o f f ru str a tio ns, o r

“v en tin g,” r e g ard in g p atie n ts a ls o o ccu rs i n o nlin e f o ru m s a n d i s n ot r e co m men ded .

In fo rm atio n g ath ere d f ro m s o cia l m ed ia c an a ls o b e u se d t o m ak e d ecis io ns r e g ard in g a d m is sio n t o m ed ic al o r p ro fe ssio nal

p ro gra m s, s e le ctio n f o r r e sid en cie s, o r e m plo ym en t. E m plo yers a n d r e sid en cy p ro gra m s n ow s e arc h F aceb ook a n d o th er s o cia l

n etw ork in g s ite s b efo re h ir in g a p plic an ts . A M ic ro so ft s u rv ey f o und t h at 7 9% o f e m plo yers v ie w o nlin e i n fo rm atio n r e g ard in g

pro sp ectiv e e m plo yees, a n d o nly 7 % o f j o b c an did ate s w ere a w are o f t h is p ossib ility . B y m ak in g p ublic p osts , a p ers o n h as

w illin gly m ad e i n fo rm atio n a v aila b le f o r a n yone t o v ie w f o r a n y p urp ose . F or s o m e, i t l o gic ally f o llo w s t h at c an did ate s w ho

don’t u se d is c re tio n i n d ecid in g w hat c o nte n t t o p ost o nlin e m ay a ls o b e i n cap ab le o f e x erc is in g s o und p ro fe ssio nal j u dgm en t.

I t i s n ot u nusu al f o r s o cia l m ed ia u se rs t o b e c o nnecte d t o o verla p pin g n etw ork s o f f rie n ds, f a m ily , a n d c o lle ag ues. S om e u se rs

tr y t o k eep t h eir p ers o nal a n d p ro fe ssio nal i m ag es s e p ara te b y c re atin g d if f e re n t a cco unts . T his m ay b e d if f ic u lt t o

im ple m en t i n p ra ctic e b ecau se p ers o nal a n d p ro fe ssio nal c o nta cts o fte n o verla p . H ow ev er, m ost s o cia l n etw ork in g s ite s n o w

pro vid e p riv acy s e ttin gs t h at a llo w i n div id uals t o c u sto m iz e b oth t h eir p ro file c o nte n t a n d w ho c an v ie w i t. I d eally , a cco unt

an d p riv acy s e ttin gs s h ould b e s e t i n a w ay t h at e n ab le s o ne’s n etw ork t o e x pan d w hile l im itin g t h e e x posu re o f i n fo rm atio n t o

p eo ple o uts id e o f t h e n etw ork . A ny s e ttin gs m ad e a v aila b le b y t h e s o cia l m ed ia s ite t h at a llo w u se rs t o l a b el d if f e re n t

re la tio nsh ip s s o t h at o nly a p pro pria te i n fo rm atio n i s s h are d w ith c erta in g ro ups o r i n div id uals s h ould a ls o b e u se d . H CPs s h ould

c o nduct p erio dic s e arc h es f o r t h eir o w n n am es o r o th er i d en tif y in g i n fo rm atio n t o e n su re t h at t h eir s o cia l m ed ia p re se n ce p ro je cts

a p ro fe ssio nal i m ag e.

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Bre ach es o f P atie nt P riv a cy

C oncern s r e g ard in g t h e u se o f s o cia l m ed ia b y H CPs f re q uen tly c en te r o n t h e p ote n tia l f o r n eg ativ e r e p erc u ssio ns r e su ltin g f ro m

th e b re ach o f p atie n t c o nfid en tia lity . S uch i n fra ctio ns m ay e x pose H CPs a n d h ealth c are e n titie s t o l ia b ility u nder f e d era l H IP A A

an d s ta te p riv acy l a w s.

H IP A A, a s m odif ie d b y t h e H ealth I n fo rm atio n T ech nolo gy f o r E co nom ic a n d C lin ic al H ealth ( H IT EC H ) a ct, g overn s t h e

perm itte d u se a n d d is c lo su re o f p atie n t i n fo rm atio n b y c o vere d e n titie s, i n clu din g H CPs a n d h osp ita ls . T he H IT EC H a ct d eta ils

p riv acy -b re ach n otif ic atio n r e q uir e m en ts a n d e x pan ds v ario us m an date s t o i n clu de b usin ess a sso cia te s. S ectio n 1 3410(d )

ad dre sse s c iv il a n d c rim in al p en altie s f o r v io la tio ns t h at a re b ase d o n t h e n atu re o f t h e v io la tio n, a s w ell a s r e su lta n t h arm .

Alth ough t h e u se o f s o cia l m ed ia i s n ’t s p ecif ic ally r e fe re n ced , t h ese t o ols c an c erta in ly p re se n t r is k s u nder H IP A A a n d H IT EC H .

An H CP m ay b re ach f e d era l H IP A A/H IT EC H o r s ta te p riv acy l a w s i n a n um ber o f w ay s w hen p ostin g i n fo rm atio n, c o m men ts ,

p hoto s, o r v id eo s c o ncern in g a p atie n t t o a s o cia l n etw ork in g s ite . W heth er c o m munic atin g w ith o r a b out p atie n ts o n s o cia l

m ed ia , b re ach es o f p atie n t c o nfid en tia lity c an r e su lt i n l e g al a ctio n a g ain st a n H CP a n d p ote n tia lly h is o r h er e m plo yer. H ow ev er,

it i s i m porta n t t o n ote t h at H IP A A d oes n ot r e str ic t t h e d is tr ib utio n o f m ed ic al i n fo rm atio n t h at h as b een “ d e-id en tif ie d .”

In 2 003, t h e D ep artm en t o f H ealth a n d H um an S erv ic es ( H HS) i s su ed t h e H IP A A P riv acy R ule , w hic h p ro vid es t h e f ir s t f e d era l

p riv acy s ta n dard s f o r t h e p ro te ctio n o f p atie n t i n fo rm atio n t o b e f o llo w ed b y “ co vere d e n titie s,” s u ch a s H CPs, h osp ita ls , a n d

health p la n s. T he H IP A A P riv acy R ule l e v ie s h eav y f in es a n d p ote n tia l c rim in al c h arg es o n t h e u nau th oriz ed d is c lo su re o f

in div id ually i d en tifia ble h ealth i n fo rm atio n b y c o vere d e n titie s i n o ra l, p ap er, o r e le ctr o nic f o rm . T he H IP A A P riv acy R ule a ls o

in clu des a “ sa fe g uard s s ta n dard ” t h at r e q u ir e s c o vere d e n titie s t o r e aso nab ly p ro te ct p atie n ts ’ h ealth i n fo rm atio n f ro m

unau th oriz ed d is c lo su re b y u sin g p hysic a l, a d m in is tr a tiv e, a n d t e ch nic al s a fe g uard s. T he s a fe g uard s ta n dard s a re s o m ew hat

fle x ib le f o r e n titie s o f d if f e re n t s iz es a n d r e so urc es. F or i n sta n ce, c o m munic atio n b etw een a p atie n t a n d a n H CP u sin g

unen cry pte d e m ail m ig ht b e p erm is sib le , a s l o ng a s o th er r e aso nab le s a fe g uard s a re f o llo w ed .

T o c o m ply w ith t h e H IP A A P riv acy R ule , c lin ic al v ig nette s p oste d o n s o cia l m ed ia c o ncern in g p atie n ts m ust h av e a ll p ers o nal

id en tif y in g i n fo rm atio n a n d a n y r e v ealin g r e fe re n ces r e m oved . T his “ d e-id en tif ic atio n” c an b e a cco m plis h ed b y c h an gin g o r

om ittin g k ey p atie n t d eta ils ( e .g ., n am es, i n su ra n ce o r S ocia l S ecu rity n um bers , d ate o f b ir th , a n d p hoto s), b y a v oid in g t h e

desc rip tio n o f r a re m ed ic al p ro ble m s, a n d b y n ot i n clu din g s p ecif ic t im e f ra m es o r l o catio ns w ith out t h e p atie n t’s

c o nse n t. H ow ev er, d esp ite t h ese p re cau tio ns, t h ere h av e s till b een m an y w ell- p ublic iz ed i n ad verte n t b re ach es o f t h e

H IP A A P riv acy R ule i n volv in g s o cia l m ed ia . P ro te ctin g a p ers o n’s i d en tity w hen w riti n g a b out p atie n ts i s o fte n m ore d if f ic u lt

t h an m ig ht b e e x pecte d . A s tu dy o f m ed ic al b lo gs w ritte n b y H CPs f o und t h at i n div id ual p atie n ts w ere d esc rib ed i n 4 2% o f t h e

271 s a m ple s s tu die d . O f t h ese s a m ple s, 1 7% w ere f o und t o i n clu de e n ough i n fo rm atio n f o r p atie n ts t o i d en tif y t h em se lv es o r

th eir p ro vid ers , a n d t h re e i n clu ded r e co gniz ab le p hoto gra p hs o f t h e p atie n ts .

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The p atie n t’s c o nse n t i s a c ritic al i s su e t o c o nsid er w hen u sin g s o cia l m ed ia . A n H CP o r h ealth c are o rg an iz atio n m ig ht d ete rm in e

w heth er p atie n t p erm is sio n i s n eed ed b y c o nsid erin g t h e p la ce o f p ublic atio n. T he u se o f s p ecif ic H IP A A-c o m plia n t m essa g in g

sy ste m s, s u ch a s t h at p ro vid ed w ith in D oxim ity , m ay b e t h eo re tic ally s a fe e v en f o r p atie n t- id en tif y in g i n fo rm atio n, a ssu m in g t h at

th e r e cip ie n t h as m ed ic al j u stif ic atio n f o r r e ceiv in g s u ch i n fo rm atio n. H ow ev er, i t i s u ltim ate ly u p t o t h e i n div id ual H CP, t h e

pra ctic e, o r t h e o rg an iz atio n t o d ecid e w hen t h ey w ill s e ek p atie n t c o nse n t b efo re p ostin g d e-id en tif ie d c ase d eta ils o nlin e.

V io la tio n o f th e P atie nt– H CP B oundary

H CPs w ho i n te ra ct w ith t h eir p atie n ts o n s o cia l m ed ia m ay b e v io la tin g t h e p atie n t– H CP b oundary e v en i f p atie n ts i n itia te t h e

onlin e c o m munic atio n. A r e cen t s tu dy f o und t h at p atie n ts o fte n e x te n d o nlin e “ frie n d” r e q uests t o t h eir p hysic ia n s o n

F aceb ook. H ow ev er, v ery f e w p hysic ia n s r e cip ro cate o r r e sp ond, s in ce i t i s g en era lly t h ought t o b e i ll- a d vis e d f o r a n H CP t o

i n te ra ct w ith a p atie n t t h ro ugh a g en era l s o cia l m ed ia f o ru m s u ch a s F aceb ook. I n a d ditio n, o rg an iz atio nal p olic y s ta te m en ts

o fte n d is c o ura g e p ers o nal o nlin e c o m munic atio n b etw een H CPs a n d p atie n ts .

H CPs s h ould t h ere fo re b eco m e f a m ilia r w ith t h e p riv acy s e ttin gs a n d t e rm s o f a g re em en ts f o r t h e s o cia l m ed ia p la tf o rm s t o w hic h

th ey s u bsc rib e s o t h at t h ey c an m ain ta in s tr ic t p riv acy s e ttin gs o n t h eir p ers o nal a cco unts . R ath er t h an “ frie n din g” o r

co m munic atin g w ith a p atie n t o n s o cia l m ed ia , H CPs c an s u ggest t h at t h e p atie n t s e t u p a w eb site t h at i s s p ecif ic ally d esig ned f o r

posts r e g ard in g m ed ic al e v en ts , s o t h at t h e H CP c an f o llo w t h e u pdate s i n a m ore p ro fe ssio nal m an ner. F or e x am ple ,

C arin gB rid ge ( w ww.c arin gbrid ge.o rg ) i s a n onpro fit w eb site t h at i s d esig ned t o c re ate a s o cia l m ed ia p re se n ce f o r p atie n ts o n a

p ro te cte d , u se r- frie n dly v en ue. P atie n ts c an u se t h eir C arin gB rid ge p ro file f o r t h e p urp ose o f i n te ra ctiv ely c o m munic atin g w ith

c o ncern ed f o llo w ers d urin g a h ealth e v en t.

P hysic ia n s m ay a ls o v io la te a p atie n t’s p ers o nal b oundary t h ro ugh t h e i n ap pro pria te u se o f i n fo rm atio n f o und o nlin e o r o n s o cia l

m ed ia . S in ce s o cia l m ed ia c an p ro vid e a w ealth o f i n fo rm atio n a b out a p atie n t, i t c an b e u se d i n a p ositiv e w ay t o a id c lin ic al

c are . T his p ra ctic e, k now n a s “ p atie n t- ta rg ete d G ooglin g,” h as b een d esc rib ed i n m an y m ed ic al s e ttin gs. A necd ota l r e p orts

h av e h ig hlig hte d s o m e b en efits t o t h is p ra ctic e ( fo r e x am ple , u sin g i n fo rm atio n f o und o n s o cia l m ed ia t o i d en tif y a n a m nesic

e m erg en cy p atie n t o r i n te rv en in g w hen a p atie n t i s b lo ggin g a b out s u ic id e). H ow ev er, t h e p ote n tia l f o r t h e b lu rrin g o f

p ro fe ssio nal a n d p ers o nal b oundarie s e x is ts , s in ce t h is p ra ctic e c an a ls o b e s p urre d b y i n ap pro pria te c u rio sity , v oyeu ris m , a n d

hab it.

A n H CP m ay o bse rv e p osts o r p hoto s o n s o cia l m ed ia s ite s t h at d ep ic t p atie n ts p artic ip atin g i n r is k -ta k in g o r h ealth -a v ers e

b eh av io rs . D ig ita lly i n vestig atin g t h e p ers o nal b eh av io rs o f p atie n ts , s u ch a s w heth er t h ey h av e q uit s m okin g o r a re m ain ta in in g

a h ealth y d ie t, c o uld t h re ate n t h e t r u st n ee d ed f o r a s tr o ng p atie n t– physic ia n r e la tio nsh ip . T here fo re , i n s u ch i n sta n ces, a n H CP

sh ould c o nsid er t h e s o urc e o f t h is i n fo rm atio n a n d u se c lin ic al j u dgm en t t o d ete rm in e w heth er a n d h ow t o r e v eal t h is d is c o very

d urin g p atie n t m an ag em en t.

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Lic e nsin g Is su es

T he u se o f s o cia l m ed ia c an a ls o a d vers e ly a ff e ct a n H CP’s c re d en tia ls a n d l ic en su re . S ta te m ed ic al b oard s h av e t h e a u th ority t o

d is c ip lin e p hysic ia n s, i n clu din g i m posin g r e str ic tio ns o r s u sp en din g o r r e v okin g l ic en se s. T hese p en altie s c an b e m ete d o ut f o r

unpro fe ssio nal b eh av io r, s u ch a s t h e i n ap pro pria te u se o f s o cia l m ed ia , s e x ual m is c o nduct, b re ach es o f p atie n t p riv acy, t h e a b use

o f p re sc rib in g p riv ile g es, a n d t h e m is re p re se n ta tio n o f c re d en tia ls .

U .S . l ic en sin g a u th oritie s h av e r e p orte d n um ero us p ro fe ssio nal v io la tio ns b y H CPs o n s o cia l m ed ia t h at r e su lte d i n d is c ip lin ary

a ctio n. F or e x am ple , a n e m erg en cy m ed ic in e p hysic ia n w as r e p rim an ded b y t h e R hode I s la n d S ta te B oard f o r “ u npro fe ssio nal

c o nduct” a n d w as f in ed a fte r m ak in g c o m men ts o n F aceb ook a b out a p atie n t. T he p hysic ia n d id n ot m en tio n t h e p atie n t’s n am e i n

t h e p ost; h ow ev er, s u ff ic ie n t i n fo rm atio n w as i n clu ded t h at a llo w ed o th ers w ith in t h e c o m munity t o i d en tif y t h e p atie n t.

M is re p re se n ta tio n o f c re d en tia ls i s o ne o f t h e m ost c o m mon o nlin e v io la tio ns r e p orte d t o s ta te m ed ic al b oard s. P hysic ia n s

sh ould b e f a m ilia r w ith t h e r e q uir e m en ts o f s ta te m ed ic al b oard s r e g ard in g o nlin e c o m munic atio ns t o e n su re t h ey d o n ot c o m mit

a n y v io la tio ns t h at m ig ht j e o pard iz e t h eir l ic en se .

N urs in g b oard s h av e a ls o d is c ip lin ed n urs e s f o r v io la tio ns i n volv in g o nlin e d is c lo su re o f p atie n ts ’ p ers o nal h ealth i n fo rm atio n a n d

hav e i m pose d s a n ctio ns r a n gin g f ro m l e tte rs o f c o ncern t o l ic en se s u sp en sio ns. T he p ostin g o f u npro fe ssio nal c o nte n t o n s o cia l

m ed ia b y H CP s tu den ts i s a ls o f a ir ly c o m mon. O ne s u rv ey f o und t h at 6 0% o f m ed ic al s c h ool d ean s r e p orte d i n cid en ts i n w hic h

stu den ts h ad p oste d i n ap pro pria te c o nte n t o nlin e, i n clu din g p atie n t i n fo rm atio n, i n ap pro pria te l a n guag e, d ep ic tio ns o f i n to xic atio n,

an d s e x ually e x plic it m ate ria l.

L egal Is su es

T he w id esp re ad u se o f s o cia l m ed ia h as i n tr o duced n ew l e g al c o m ple x itie s. A n um ber o f c o nstitu tio nal r ig hts c an b e a p plie d t o

t h e u se o f s o cia l m ed ia , s u ch a s f re ed om o f s p eech , f re ed om f ro m s e arc h a n d s e iz u re , a n d t h e r ig ht t o p riv acy ; h ow ev er, t h ese

rig hts c an b e s u ccessfu lly c h alle n ged .

In 2 009, a U .S . D is tr ic t C ourt u pheld t h e e x puls io n o f a n urs in g s tu den t f o r v io la tin g t h e s c h ool’s h onor c o de b y m ak in g o bsc en e

re m ark s a b out t h e r a ce, s e x , a n d r e lig io n o f p atie n ts u nder h er c are . T he c o urt c o nclu ded t h at t h e s c h ool’s h o nor c o de a n d

co nfid en tia lity a g re em en t s ig ned b y e ach n urs in g s tu den t g overn ed t h e s ta n dard s o f a ccep ta b le b eh av io r, d is m is sin g t h e s tu den t’s

c la im t h at h er r ig ht t o f re ed om o f s p eech h ad b een v io la te d . A s im ila r r u lin g w as m ad e i n a c ase i n w hic h a s tu den t p oste d

p ic tu re s o f h ers e lf a s a d ru nken p ir a te o n M yS pace.

L eg al c ase s s h ould n ev er b e d is c u sse d o n s o cia l m ed ia b ecau se m ost c u rre n t c ase l a w d ic ta te s t h at s u ch i n fo rm atio n i s

“ d is c o vera b le ,” a lth ough t h is m ay d ep en d o n t h e p urp ose f o r w hic h t h e i n fo rm atio n i s s o ught. E ven i f i t i s p oste d

an onym ously , v ario us i n vestig ativ e m eth o ds m ay p ote n tia lly b e u se d t o d ir e ctly l in k l e g al i n fo rm atio n t o a s p ecif ic p ers o n o r

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in cid en t. T he F aceb ook p olic y f o r t h e u se o f d ata i n fo rm s u se rs t h at “ w e m ay a ccess, p re se rv e, a n d s h are y our i n fo rm atio n i n

r e sp onse t o a l e g al r e q uest” b oth w ith in a n d o uts id e o f U .S . j u ris d ic tio n. T he p olic y a ls o s ta te s t h at i n fo rm atio n m ay b e s h are d

fo r a n um ber o f r e aso ns, i n clu din g t o a id i n vestig atio ns, t o p re v en t f ra u d o r i lle g al a ctiv ity , a n d t o p ro te ct F aceb ook, t h e u se r, o r

an yone e ls e . I n fo rm atio n p oste d o n s o cia l m ed ia c an a ls o b e u se d t o p ortr a y — rig htly o r w ro ngly — an i m ag e o f a n i n div id ual’s

c h ara cte r i n l a w su its .

H CPs c an a ls o e x pose t h em se lv es t o l a w su its i f t h ey r e sp ond t o a q uestio n s e n t v ia s o cia l m ed ia b y p ro vid in g m ed ic al a d vic e. I t

h as b een s u ggeste d t h at a l e g ally s o und a p pro ach i n r e sp onse t o r e q uests f o r s u ch a d vic e w ould b e t o s e n d a s ta n dard r e sp onse

fo rm t h at: 1 ) i n fo rm s t h e i n quir e r t h at t h e H CP d oes n ot a n sw er o nlin e q uestio ns; 2 ) s u pplie s o ff lin e c o nta ct i n fo rm atio n s o t h at a n

a p poin tm en t c an b e m ad e, i f d esir e d ; a n d 3 ) i d en tif ie s a s o urc e f o r e m erg en cy s e rv ic es i f t h e i n quir e r c an not w ait f o r a n

a p poin tm en t. I n c ir c u m sta n ces w here a p atie n t– H CP r e la tio nsh ip a lr e ad y e x is ts , i n fo rm ed c o nse n t s h ould b e o bta in ed p rio r t o

o nlin e d is c u ssio ns b etw een t h e H CP a n d t h e p atie n t r e g ard in g m ed ic al c are . A c are fu l e x pla n atio n r e g ard in g t h e r is k s o f o nlin e

co m munic atio n, e x pecte d r e sp onse t im es, a n d t h e h an dlin g o f e m erg en cie s s h ould b e i n clu ded . T he i n fo rm ed c o nse n t a n d a n y

onlin e i n te ra ctio ns s h ould b e d ocu m en te d i n t h e p atie n t’s c h art.

P R O FE SSIO NAL G UID ELIN ES F O R T H E U SE O F S O CIA L M ED IA

S ocia l M edia G uid elin es Is su ed b y H ealt h C are In stit u tio n s

Socia l m ed ia p ose m an y r is k s f o r h ealth c are o rg an iz atio ns t h at c o uld p ote n tia lly a ff e ct t h e s a fe ty a n d s e cu rity o f p atie n t

in fo rm atio n, p atie n t c o nse n t, e m plo ym en t p ra ctic es, p hysic ia n c re d en tia lin g a n d l ic en su re , t h e v io la tio n o f H CP–patie n t

boundarie s, a n d o th er e th ic al i s su es. T here fo re , i t w ould b e b en efic ia l f o r h ea lth c are o rg an iz atio ns t o e sta b lis h e m plo yee

g uid elin es r e g ard in g t h e a p pro pria te u se o f s o cia l m ed ia . A l is t o f p oin ts t h at m ig ht b e a d dre sse d i n o rg an iz atio nal s o cia l

m ed ia p olic ie s i s p re se n te d i n T ab le 1 . C onse q uen ces r e g ard in g p olic y v io la tio ns s h ould a ls o b e d efin ed .

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Ta ble 1

C oncep ts f o r H ealth C are O rg an iz atio ns’ S ocia l M ed ia P olic ie s

A ddre ss d is c rim in atio n, h ara ssm en t, w ro ngfu l t e rm in atio n, l e ak in g o f c o nfid en tia l o r p ro p rie ta ry i n fo rm atio n, d am ag e t o t h e

org an iz atio n’s r e p uta tio n, p ro ductiv ity , a n d o th er i s su es.

A ddre ss e x pecta tio ns r e g ard in g e m plo yee b eh av io r o uts id e t h e r e alm o f e m plo y m en t.

B an , l im it, a n d/o r m onito r e m plo yee a ccess t o t h e I n te rn et a n d/o r t o s o cia l n etw ork in g s ite s.

D efin e e m plo yees’ r e sp onsib ilitie s w hen w itn ess in g i n ap pro p ria te u se o f s o cia l m ed ia .

D efin e p olic y r e g ard in g t h e u se o f o rg an iz atio nal e m ail a d dre sse s a n d g ra p h ic s o r l o g os.

D efin e d is c ip lin ary a ctio ns f o r t h e i n ap pro pria te u se o f s o cia l m ed ia .

D esig nate w ho c an a ccess s o cia l m ed ia o n t h e o rg an iz atio n ’s p re m is e s a n d f o r w hat p urp o se .

E nsu re t h at m ed ic al s ta ff a n d e m plo yees a ck now le d g e t h at t h ey a re n ot r e p re se n tin g t h e o rg an iz atio n w hen t h ey p ost m ate ria l t o t h eir

p ers o nal s o cia l m ed ia s ite s.

E nsu re t h at m ed ic al s ta ff a n d e m plo yees d is c lo se a n y c o nflic ts o f i n te re st.

E nsu re t h at t h e m ed ic al s ta ff a n d e m plo yees a re f a m ilia r w ith s ta te a n d f e d era l g uid elin es r e g ard in g p atie n ts ’ p riv acy.

E nsu re t h at t h e m ed ic al s ta ff a n d e m plo yees i n clu d e a d is c la im er w hen t h ey a re n ot s p eak in g o n b eh alf o f t h e o rg an iz atio n.

E nsu re t h at t h e m ed ic al s ta ff , e m plo yees, a n d s tu den ts u nders ta n d t h e n eed t o a d here t o t h e o rg an iz atio n’s s o cia l m ed ia p olic y.

R ev is e o r e x pan d c u rre n t p olic ie s r e g ard in g p atie n t c o nse n t a n d t h e p ostin g o f p atie n t i n fo rm atio n o n s o cia l m ed ia .

O pen i n a s e p ara te w in dow

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Health c are i n stitu tio ns s h ould a d dre ss t h e r is k s p ose d b y t h e u se o f s o cia l m ed ia i n t h eir e m plo yee p olic ie s. P olic ie s s h ould

e n co m pass d is c rim in atio n, h ara ssm en t, w ro ngfu l t e rm in atio n, l e ak in g o f c o nfid en tia l o r p ro prie ta ry i n fo rm atio n, d am ag e t o t h e

org an iz atio n’s r e p uta tio n, a n d p ro ductiv ity a s w ell a s o th er i s su es. A h ealth c are o rg an iz atio n m ay a ls o c o nsid er e sta b lis h in g

polic ie s t h at i n volv e d is c ip lin ary a ctio ns i n r e sp onse t o e m plo yees’ u se o f t h e I n te rn et, c ellp hones, o r t a b le ts d urin g w ork in g

hours . T he e sta b lis h m en t o f s u ch p olic ie s c o uld d im in is h a n um ber o f c o ncern s r e g ard in g t h e o nlin e p ostin g o f p ic tu re s o r o th er

p atie n t i n fo rm atio n t h at c o uld v io la te f e d era l o r s ta te p riv acy l a w s o r c o uld d is tr a ct f ro m p atie n t c are .

M an y i n stitu tio nal p olic ie s a ls o p ro hib it t h e u se o f w ork e m ail a d dre sse s o n s o cia l m ed ia , r e fle ctin g a c o ncern f o r s e cu rity a n d t h e

im porta n ce o f s e p ara tin g p ers o nal a n d p ro fe ssio nal a ctiv itie s. T he u se o f i n stitu tio nal g ra p hic s o r l o gos o n e m plo yees’ p ers o nal

so cia l m ed ia p ag es m ay a ls o b e p ro hib ite d . P ote n tia l c o nflic ts o f i n te re st a re a ls o a c o ncern . M ost p olic ie s p ro hib it a rra n gem en ts

th at i n volv e t h e e x ch an ge o f m oney f o r o nlin e p ostin gs o r o th er a ctiv itie s, a n d r e q uir e f u ll d is c lo su re w ith d is c la im ers i f s u ch a

r e la tio nsh ip e x is ts .

S ev era l h ealth c are i n stitu tio ns h av e p olic ie s t h at r e q uir e a s ig ned H IP A A a u th oriz atio n b efo re a n y p atie n t- s p ecif ic i n fo rm atio n

m ay b e p oste d o n s o cia l m ed ia . O th er i n stitu tio ns, p artic u la rly m ed ic al s c h ools , h av e e x pan ded t h is c o ncep t t o i n clu de c o nse n t

fro m r e se arc h s u bje cts a n d v olu nte ers . I t i s g ood p ra ctic e f o r f a cu lty a t e d ucatio nal i n stitu tio ns t o i n fo rm s tu den ts a b out p ote n tia l

c o nse q uen ces f o r v io la tin g t h is a n d o th er s o cia l m ed ia g uid elin es, s in ce s u ch i n fra ctio ns m ay n ot o nly e x pose t h e s tu den t t o

a cad em ic o r p ro fe ssio nal d is c ip lin ary a ctio ns b ut c an a ls o v io la te s ta te a n d f e d era l l a w s, r e su ltin g i n c iv il a n d c rim in al p en altie s.

A dditio nal i n fo rm atio n r e g ard in g s o cia l m ed ia g uid elin es c an b e f o und i n t h e o nlin e d ata b ase a t

h ttp ://s o cia lm ed ia g overn an ce.c o m /p olic ie s . T his r e so urc e i n clu des 2 47 s o cia l m ed ia p olic ie s, m an y f o r h ealth c are i n stitu tio ns

or p ro fe ssio nal s o cie tie s, s u ch a s t h e M ay o C lin ic , K ais e r P erm an en te , a n d t h e A m eric an N urs e s A sso cia tio n.

S ocia l M edia G uid elin es fo r H CPs Is s u ed b y P ro fe ssio n al O rg aniz a tio n s

M an y h ealth c are p ro fe ssio nal s o cie tie s h av e i s su ed g uid elin es f o r t h e u se o f s o cia l m ed ia . I n 2 012, t h e A SH P r e le ase d a s ta te m en t

re g ard in g t h e u se o f s o cia l m ed ia b y p harm acis ts . T he A SH P a d vis e d p harm acis ts t o p ro v id e c lin ic al a d vic e o nly i n a d here n ce

w ith p ro fe ssio nal s ta n dard s ( i.e ., w hen a c o m ple te h is to ry i s k now n); t o r e co gniz e w hen a p atie n t’s n eed s w ould b e b ette r m et b y

oth er m ean s o f c o m munic atio n; t o p ro vid e t im ely a n d a ccu ra te i n fo rm atio n w hen a p pro pria te ; t o r e b ut a n y m is le ad in g

in fo rm atio n; t o p ro te ct p atie n t p riv acy ; a n d t o m ain ta in t h e p harm acis t’s r e p uta tio n d urin g a n onym ous o r p ers o nal u se o f s o cia l

m ed ia . T he A SH P a ls o r e co m men ded t h at h osp ita ls o r h ealth s y ste m s t h at a llo w t h e u se o f s o cia l m ed ia e sta b lis h b est p ra ctic es i n

t h e f o rm o f p olic ie s a n d p ro ced ure s t h at b ala n ce t h e b en efits o f s o cia l m ed ia w ith t h e p ote n tia l r is k s a n d l ia b ilitie s o f s u ch m ed ia .

In 2 010, t h e A m eric an M ed ic al A sso cia tio n ( A M A) r e le ase d o ff ic ia l g uid elin es f o r t h e e th ic al u se o f s o cia l m ed ia b y p hysic ia n s.

T hese g uid elin es e m phasiz e t h e n eed t o m ain ta in p atie n t c o nfid en tia lity ; t o b e c o gniz an t o f p riv acy s e ttin gs; t o m ain ta in

a p pro pria te p atie n t– physic ia n b oundarie s; t o p ro vid e a ccu ra te a n d t r u th fu l i n fo rm atio n; t o a ct w ith c o lle g ia lity ; t o a v oid

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an onym ity ; t o d ecla re c o nflic ts o f i n te re st; a n d t o m ain ta in s e p ara te p ers o nal a n d p ro fe ssio nal p ro file s. T he A M A’s p olic y

als o r e co m men ds t h at m em bers b e a w are t h at p riv acy s e ttin gs m ay n ot p ro vid e c o m ple te p ro te ctio n a n d t h at a n yth in g p oste d o n

th e I n te rn et m ay b e p erm an en tly a v aila b le o nlin e.

T he F ed era tio n o f S ta te M ed ic al B oard s ( F A SB ) p ublis h ed a g uid an ce d ocu m en t o n t h e a p pro pria te u se o f s o cia l m ed ia i n m ed ic al

p ra ctic e i n 2 011 . T his d ocu m en t e m phasiz es p ro te ctio n o f p atie n t p riv acy a n d c o nfid en tia lity ; p ro fe ssio nalis m a n d t r a n sp are n cy ;

th e a v oid an ce o f d is p en sin g m ed ic al a d v ic e o nlin e; a n d t h e c av eat t h at o nce i n fo rm atio n i s p la ced o nlin e, i t c an b e d is tr ib ute d

in te rm in ab ly .

T he N atio nal C ouncil o f S ta te B oard s o f N urs in g ( N CSB N ) a ls o i s su ed i ts W hite P aper: A N urse ’s G uid e t o t h e U se o f S ocia l

M ed ia i n 2 011 . T his d ocu m en t i n clu des p ra ctic al g uid elin es f o r g overn in g t h e a p pro pria te u se o f s o cia l m ed ia i n t h e h ealth c are

e n vir o nm en t b y n urs e s. A s u m mary o f c o ncep ts i n clu ded i n m ost p ro fe ssio nal g uid elin es i s p re se n te d i n T ab le 2 .

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Ta ble 2

C om mon G uid elin es f o r t h e U se o f S ocia l M ed ia b y H CPs 7,15 7/22/2020 Social Media and Health Care Professionals: Benefits, Risks, and Best Practices

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Open i n a s e p ara te w in dow

C O NCLU SIO N

Con te x t C on cep t

C onte n t c re d ib ility

S hare o nly i n fo rm atio n f ro m c re d ib le s o urc es.

R efu te a n y i n accu ra te i n fo rm atio n y ou e n co unte r.

L eg al c o ncern s

R em em ber t h at t h e c o nte n t y ou a u th or m ay b e d is c o vera b le .

C om ply w ith f e d era l a n d s ta te p riv acy l a w s.

R esp ect c o pyrig ht l a w s.

L ic en sin g

co ncern s K now p ro fe ssio nal l ic en su re r e q uir e m en ts f o r y our s ta te .

N etw ork in g

pra ctic es D o n ot c o nta ct p atie n ts w ith r e q uests t o j o in y ou r n etw ork .

D ir e ct p atie n ts w ho w an t t o j o in y our p ers o nal n etw ork t o a m ore s e cu re m ean s o f c o m munic atio n o r t o y our

pro fe ssio nal s ite .

P atie n t c are

A void p ro vid in g s p ecif ic m ed ic al a d vic e t o n onpatie n ts .

M ak e a p pro pria te d is c lo su re s a n d d is c la im ers r e g ard in g t h e a ccu ra cy, t im elin ess, a n d p riv acy o f e le ctr o nic

c o m munic atio ns.

P atie n t p riv acy

A void w ritin g a b out s p ecif ic p atie n ts .

M ak e s u re y ou a re i n c o m plia n ce w ith s ta te a n d f e d era l p riv acy l a w s.

O bta in p atie n t c o nse n t w hen r e q uir e d . 7/22/2020 Social Media and Health Care Professionals: Benefits, Risks, and Best Practices

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When u se d w is e ly a n d p ru den tly , s o cia l m ed ia s ite s a n d p la tf o rm s o ff e r t h e p ote n tia l t o p ro m ote i n div id ual a n d p ublic h ealth , a s

w ell a s p ro fe ssio nal d ev elo pm en t a n d a d v an cem en t. H ow ev er, w hen u se d c are le ssly , t h e d an g ers t h ese t e ch nolo gie s p ose t o

H CPs a re f o rm id ab le . G uid elin es i s su ed b y h ealth c are o rg an iz atio ns a n d p ro fe ssio nal s o cie tie s p ro vid e s o und a n d u se fu l

prin cip le s t h at H CPs s h ould f o llo w t o a v oid p itf a lls .

G lo ssa ry

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App A s o ftw are p ro gra m t h at p erfo rm s a s p ecif ic f u nctio n t h at i s u se d o n a c o m pute r o r m obile d ev ic e.

A vata r A g ra p hic o r i llu str a tio n t h at r e p re se n ts a p artic u la r p ers o n i n a c o m pute r g am e o r o n a n I n te rn et s ite .

B lo g A n i n te ra ctiv e w eb site , o r p art o f a w eb site , m ain ta in ed b y a n i n div id ual, a g ro up o f i n div id uals , o r a n

o rg an iz atio n t h at p osts r e g ula r e n tr ie s o f c o m men ta rie s a n d e v en ts .

C ro w dso urc e H arn essin g t h e k now le d ge b ase a n d s k ill s o f a n e x te rn al c o m munity f o r t h e p urp ose o f c o lla b ora tiv ely s o lv in g

pro ble m s, s h arin g k now le d ge, o r g ath erin g o pin io ns.

D ir e ct

m essa g e

P riv ate m essa g es b etw een T w itte r u se rs .

H an dle T he u niq ue u se r n am e s e le cte d b y a T w it te r u se r. I t i s d esig nate d b y a n “ @ use rn am e” i d en tif ie r.

H ash ta g T he # s y m bol u se d i n f ro nt o f k ey w ord s t o i n dex a n d m ak e t h e t o pic o f a t w eet s e arc h ab le .

L is t P ublic ly o r i n div id ually c u ra te d g ro ups o f T w itte r u se rs .

M ic ro blo g A W eb s e rv ic e t h at a llo w s s u bsc rib ers t o s e n d s h ort m essa g es t o o th er s u bsc rib ers .

P odcast A udio o r a u dio vis u al c o nte n t t h at c an b e d ow nlo ad ed t o a c o m pute r o r m obile d ev ic e f o r l a te r p la y back .

R e-tw eet T he r e d is tr ib utio n o f a t w eet f ro m a n oth er u se r o n T w itte r t o a u se r’s p ers o nal n etw ork .

T ag s N am es o r k ey w ord s a d ded t o b lo g p osts o r p hoto s.

T im elin e A r e al- tim e l is t o f p osts o n F aceb ook.

T w eet A T w itte r m essa g e, w hic h b y d efin itio n m ust b e n o m ore t h an 1 40 c h ara cte rs .

W ik i A c o lla b ora tiv e w eb site t h at c an b e d ir e c tly e d ite d b y a n yone w ith a ccess t o t h e s ite .

R EFE R EN CES

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P harm . 2 014; 10 (1 ):2 56–270. [P ubM ed ] [G oogle S ch ola r ] 7/22/2020 Social Media and Health Care Professionals: Benefits, Risks, and Best Practices

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2 012; 28 (3 ):2 06–209. [P ubM ed ] [G oogle S ch ola r ]

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H ealth c R is k M an ag . 2 012; 31 (4 ):4 1–47. [P ubM ed ] [G oogle S ch ola r ]

5 . V on M uhle n M , O hno-M ach ad o L . R ev ie w in g s o cia l m ed ia u se b y c lin ic ia n s. J A m M ed I n fo rm A sso c. 2 012; 19 (5 ):7 77–781.

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w ww.a sh p.o rg /D ocL ib ra ry /B estP ra ctic es/A uto IT StS ocia lM ed ia .a sp x . A ccesse d M arc h 3 0, 2 014. [ P ubM ed ]

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2 012; 8(5 ):1 1 4–124. [P M C f re e a rtic le ] [P ubM ed ] [G oogle S ch ola r ]

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2 013; 56 (3 ):4 53–462. [P M C f re e a rtic le ] [P ubM ed ] [G oogle S ch ola r ]

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In fo rm . 2 013; 183 :2 44–248. [P ubM ed ] [G oogle S ch ola r ]

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fro m t h e A m eric an C olle g e o f P hysic ia n s a n d t h e F ed era tio n o f S ta te M ed ic al B oard s. A nn I n te rn M ed . 2 013; 158 (8 ):6 20–627.

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2 014; 15 (2 ):1 68–172. [P ubM ed ] [G oogle S ch ola r ]

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O bste t G yneco l. 2 013; 56 (3 ):4 95–508. [P ubM ed ] [G oogle S ch ola r ] 7/22/2020 Social Media and Health Care Professionals: Benefits, Risks, and Best Practices

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2013; 127 (1 3):1 413–1421. [P ubM ed ] [G oogle S ch ola r ]

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lim ita tio ns o f s o cia l m ed ia f o r h ealth c are p ro fe ssio nals . J M ed I n te rn et R es. 2 013; 15 (4 ):e 8 5. [P M C f re e a rtic le ] [P ubM ed ]

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2 013; 53 (6 ):5 61–564. [P ubM ed ] [G oogle S ch ola r ]

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2050. [P ubM ed ] [G oogle S ch ola r ]

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A rtic le s fr o m Pharm acy a nd T hera peutic s a re p ro vid ed h ere c o urte sy o f M ed iM ed ia , U SA