Some blogs include ads, patient photos
Although blatant violations of patient privacy are rare, supposedly anonymous medical bloggers who provide information about their location, subspecialty or other personal details may reveal their identity to blog readers, says Tara Lagu, MD, PhD, a clinical scholar with the Robert Wood Johnson Foundation in Princeton, NJ. Her recent research with colleagues at the University of Pennsylvania in Philadelphia, found that in some cases, patients described in medical blogs may be able to identify themselves.
For example, three of the blogs in the study had recognizable photos of patients, including one with an extensive description of the patient and links to photos.
The researchers also found that some of the medical blogs allowed advertisements, and some promoted health care products within the blog text. None of the bloggers who described products within the text adhered to medical ethics standards of providing information on conflicts of interest, or whether payment was received for promotion of the products.
"While many medical blogs provide valuable information to the public, are respectful in tone and are written anonymously, others pose a threat to patient privacy and have the potential to threaten the integrity of the medical profession," Lagu says. "Unfortunately, no professional organization has taken the initiative to provide guidance on this issue. As the number of medical blogs grows, professional organizations, medical educators, and the blogging community must address the challenge of this new medium by setting guidelines and standards for what is appropriate."
Lagu and her colleagues defined medical blogs as those that contain some medical content and were apparently written by physicians or nurses. They used the Google search term "medical blog" to begin a modified snowball sampling method to identify sites posting entries from Jan. 1, 2006, to Dec. 14, 2006. They identified 271 medical blogs, with more than half of blog authors providing sufficient information in text or image to reveal their identities. Individual patients were described in 114 (42.1%) blogs. Patients were portrayed positively in 43 blogs (15.9%) and negatively in 48 blogs (17.7%).
Of blogs that described interactions with individual patients, 45 (16.6%) included sufficient information for patients to identify their doctors or themselves. Three blogs showed recognizable photographic images of patients. Health care products were promoted, either by images or descriptions, in 31 (11.4%) blogs.
Tips for reducing risk from health care blogs
When trying to protect patient privacy in online postings, risk managers will be able to exert more control over employed physicians but can apply some of the same principles to all doctors. Here are some ideal ways for hospital risk managers to protect their organizations:
- Require doctors to register their blogs with the hospital. This is a key step to creating accountability, says Wilson Chen, JD, a health care attorney in Los Angeles. The hospital should periodically survey the registered blogs to see if the doctors are violating the privacy of patients.
- Require doctors to prominently display privacy notices and terms of use on the blog. Chen notes that different states may have different standards for what level of notice is required. California, for example, has especially stringent privacy notice standards.
- Allow doctors to blog only under their real names no anonymous postings or pseudonyms. Many doctors mistakenly believe that they can remain anonymous on the blogosphere if they just use a fake name, Chen says. Nothing is further from the truth. It is very easy to track down any web site owner's information by looking at their domain registry data. By requiring doctors to use their real names, they will be more careful about what they write. They will no longer have a false sense of security, and they will take care not to damage their personal careers, Chen says.
- Consider hosting the doctors' blogs on the hospital's main web site. This way the hospital will have more control over the quality of the writing, and the additional traffic can increase the prestige of the hospital, Chen says.
- Provide basic training material regarding sharing information about patients online. Chen offers this rule of thumb: If it is not something you would talk about in a room full of reporters, then it is not something you should share on a blog. "I know this sounds like an exaggeration, but there are literally millions of people crawling the web looking for dirt they can submit to sites like Digg, Consumerist, or Healthcare Hacks," he says.
- Remind doctors that they are putting themselves at risk if they breach patient privacy. Some doctors are sure to say that it's none of your business if the protected information is controlled by the hospital, so A. Kevin Troutman, JD, an attorney with the law firm of Fisher & Phillips LLP in Houston, says you may make more headway by offering them some friendly advice rather than issuing orders.
"Make the doctors aware of how it exposes them to liability, and maybe the hospital, too," he says. "Try to make it more of a positive thing by saying you want to help them avoid liability, and at the same time that helps the hospital avoid liability, too. Tell them this kind of blog is not good for them any more than it's good for you." - Update medical staff bylaws to include online posting. Make sure your bylaws include a process for addressing this modern risk to privacy. A good way to get your physicians' attention is to review the bylaws with them and point out how blogging is covered or will be soon, Troutman says.
Source
For more information on preventing privacy breaches in blogs, contact:
- Wilson Chen, JD, Attorney, Los Angeles. E-mail: [email protected].
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content