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Using social or professional networking websites can breach confidentiality
An article for physicians by physicians
Originally published June 2010
W10-005-E

The concept of public places has expanded in recent years to include not only physical spaces but also virtual ones. While physicians are aware that disclosing patient information in public spaces such as hallways and elevators may breach their duty to protect patient confidentiality and privacy, they may not realize similar discussions on social networking or professional websites can also constitute a breach. Facebook® , Twitter®, teaching sites run by medical schools (e.g., study groups), and professional sites run by associations and societies are public spaces. Password protected sites may give users a false sense of security that they’re in an exclusive environment.

Hospitals and other medical facilities increasingly recognize the risks posed by social media and prohibit access to social networking sites using the organization’s computers. This, of course, does not prevent people from accessing those sites using private computers.

Users of social networks or discussion websites typically share their thoughts and experiences among a circle of “friends” or “colleagues,” but that circle can become much larger than you might think. For example, when you have a challenging patient you may want to pose questions or share experiences with your online friends. These friends may find the issues equally interesting and forward the information to their friends, who are not known to you. Once even a single online friend receives information, that information is no longer within your control and may be circulated rapidly and indiscriminately. Most user agreements governing these websites state that the website owners cannot control this and take no responsibility for the spread of information. This circulation of information could not only be embarrassing for you, but could also breach a patient’s privacy and harm the patient emotionally.

Another factor to consider is the content of any information you share. Because clinical challenges may be related to an unusual medical condition or the social circumstances of the patient, mentioning the condition or other details may inadvertently identify the patient, even if his or her name is not stated. If you are posting information on a social networking website, avoid including any information that could identify a patient.

Social media also includes blogs and wikis, which are increasingly used in medical education, either formally as part of the curriculum or informally as the online equivalent of a study group. As with social networking websites, teachers and students should be aware of the importance of maintaining patient confidentiality in blogs and wikis, as well as the policies governing their use.