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Hey everybody, this is Steve Christiansen
and in this brief screencast I hope to share with you some of the highlights
of a talk I gave recently discussing electronic social media tools for ophthalmology education.
specifically how to protect your patients, your profession, and you
we're all very familiar with the bad and the ugly of using social media professionally
we see stories online of physicians, nurses, and other healthcare providers
being fired or disciplined for comments that they've made on social media
that put patient safety and privacy at risk.
The American Academy of Ophthalmology recently published an advisory opinion
talking about social media and professionalism, in which they gave several recommendations
on best practices and how physicians, and particularly, ophthalmologists
can use social media, in a way that is professional and protects patient privacy.
can use social media, in a way that is professional and protects patient privacy.
can use social media, in a way that is professional and protects patient privacy.
This is a picture of Austin Chiang, MD
Dr. Chiang recently started the #VerifyHealthcare campaign
in which he encouraged physicians and other healthcare providers
to be transparent in their qualifications
so that others that may be following and reading their content
could be informed that they are experts in the areas which they are discussing
and that they can trust the information that is coming from them.
So the Academy encourages us to state our qualifications and our competence
in the things we are discussing online.
in the things we are discussing online.
This is a picture of Andrea Tooley
This is a picture of Andrea Tooley
and her stating her qualifications and her experience
as a medical student, and as an intern, and as a resident, and now currently as a fellow.
The Academy encourages us to be honest
and have integrity in our communications with the public.
This is a completely fake advertisement that I just created for the purposes of teaching
This is a completely fake advertisement that I just created for the purposes of teaching
This is a completely fake advertisement that I just created for the purposes of teaching
how NOT to go about communicating with the public.
This is a picture of Jay Sridhar, who is a fantastic vitreoretinal surgeon in Florida,
and this is a pseudo-ad that he may create
that says that he is "America's #1 Refractive Retinal Surgeon,"
and that he has a 20/20 vision guarantee,
and that we can "count on Jay's fingers for perfect vision."
Now clearly these things are a little bit disingenuous and may mislead the public,
and for that purpose the Academy is encouraging us to NOT have ads such as this one,
but to be honest in the things that we are using in our advertisements
but to be honest in the things that we are using in our advertisements
and our marketing with the public.
We're also encouraged to state our conflicts of interests when we're maybe discussing things in
social media posts, or on our blogs, or so forth of which we may be conflicted.
This is a very small photo of an article that was recently published
in the hematology-oncology literature, in which
they looked at Twitter accounts of those hematology-oncologists that
that have conflicts of interests and that tweet about them.
And they found that a very, very small percentage
of those individuals actually state their conflicts.
We should also be very careful to maintain patient confidentiality.
This is an example of a tweet in which the individual said,
"Today between the hours of 11 and 3 PM I had 18 patients
who attempted suicide or had suicidal thoughts...this is a major issue."
Now clearly this is a major issue, but this individual needs to be careful
about not giving so much information - that perhaps the
patients, and the families of those patients that they saw
in the emergency room, or in the clinic
that they could then identify that they were an individual that was being discussed here.
Now clearly, this individual was not giving the patient's names, their date of birth
and those sorts of things, but this is a little bit of a grey area, when maybe this was
not the best thing to be tweeting about this type of a topic.
This is maybe a better example. This individual said,"Today was the weirdest day ever.
And thanks to HIPAA, I can't tell you about it!"
So when you're posting on Facebook or posting on Twitter or Instagram about patients
You need to just run that tweet or that post through your mental filter two or three extra times
to be sure - 'am I saying something I shouldn't?'
and if you think that you may be, then you need to delete that tweet,
and just forget about it, and move on -
because we don't want to put any of our patient's confidentiality at risk.
because we don't want to put any of our patient's confidentiality at risk.
Here are a few examples.
Here are a few examples.
This is Jesse Berry, and she is a fantastic ocular oncologist in Southern California -
and Jesse posts some wonderful photos of patients
that she cares for - many of which have retinoblastoma.
Now what I like so much about this post from Jesse
is that you can see, about three lines down from the top right
that she says, "Posted with permission."
Now when I see this post, I immediately think, 'uhh, yikes, that's a patient!'
but then, when I see, "Posted with permission,"
1. I already trust Jesse, and I know that her posts are fantastic
and she very much appreciates HIPAA, but I also appreciate that she states
that these photos are posted with permission, because then I know
that that family is aware, and this patient is aware of what's happening.
This is another example from one of Jesse's recent Instagram posts.
She's posing here with one of her colleagues
and it's a fantastic post - the thing that's
a little bit risky, and I know that in Jesse's circumstance she thought about this
but for everyone that's considering posting pictures from the operating room and so forth,
You can see that on the background is a white board of the OR schedule for that day.
You can see that on the background is a white board of the OR schedule for that day.
There's no patient information, there's no medical record numbers, there's no dates of birth,
There's no patient information, there's no medical record numbers, there's no dates of birth,
but it is the information from that schedule for the operating room that day.
So if you are going to post pictures from the operating room, be sure that you're not
posting anything whose background has identifiable information.
This is an example of a refractive surgeon that's posing here with
several of his patients who seemingly are happy and satisfied after successful refractive surgery.
This is a great example of a post from the practice, and from this physician
that he is posing with these patients - and this is okay, as long as those patients
have given permission for these posts to be published.
And I trust, in this circumstance, that they have.
This is an example of the same physician, but maybe this is even a better example
of how physicians can use social media.
of how physicians can use social media.
In this case, this is the patient's Instagram profile that he is posting a picture with his surgeon.
And so, if a patient posts something posing with you as a doctor, you don't need to worry
about HIPAA because the patient is choosing to publish that on their own platform,
about HIPAA because the patient is choosing to publish that on their own platform,
and that's perfectly ok.
Here's an example from Usiwoma Abugo
who is a wonderful oculoplastic surgeon and
has an incredible Instagram following at @mentormemd.
This is an example of a 'before' and 'after' photo.
Now you may think, 'Is this OK? or is this not OK?'
Well this is totally OK - this is not a full face photo
which, by HIPAA standards, full face photos are not allowed,
and, you can see that it's just a 'before' and 'after,' of a surgery that she had performed.
Now, this is OK because it's not identifiable, #1, and
and then, #2, because it's not a full face photo.
Where physicians can get into a little bit of trouble in terms of posting pictures
of things that are not of the full face, are if there is an accompanying
characteristic of that photo that is identifiable.
For example, if this patient had a very unique tattoo on their skin
that was just next to their lateral canthus or next to this lesion which was removed,
that was just next to their lateral canthus or next to this lesion which was removed,
and that patient could then identify themselves
or their family or friends could identify that this was their picture, based on that tattoo,
then this would violate HIPAA. So, you just need to be careful.
then this would violate HIPAA. So, you just need to be careful.
Is it identifiable or is it not? And if it's not, it's perfectly OK.
Is it identifiable or is it not? And if it's not, it's perfectly OK.
Here are just some best practices to minimize risk when using social media professionally.
1. Train your staff - train all your employees - because those employees
need to understand the dangers of using social media at work
and posting things about work, and about patients -
and they need to understand that just in their day-to-day workplace environment
what is and isn't OK.
And then a separate training needs to be done with the marketing team
to make sure that they know what
is and isn't OK in terms of posting content online.
2. Never violate HIPAA.
We all know the HIPAA laws but we need to just be reminded about these
when we're starting to use social media professionally.
Ensure that photos are de-identified and unidentifiable.
Post about conditions and not about specific cases.
Stay vague in the timing that you are mentioning in your post.
Use the term "recently" instead of "yesterday."
For example, you could post
"I recently did this surgery and here's a video of the surgical procedure,"
instead of saying, "Yesterday I did this surgery, and here's a video" -
because heaven-forbid there was a complication and then that patient could identify
their complication as being from 'yesterday' based on the date in which it was published.
3. Obtain written patient consent, and that somewhat goes without saying.
4. Separate your personal and professional social media profiles.
5. Never offer medical advice on social media.
5. Never offer medical advice on social media.
Once again, this is Steve Christiansen, discussing
electronic social media tools for ophthalmology education
protecting your patients, your profession, and you. Thanks for watching.
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