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Rowan - Dangers and opportunities for social media

Talk for Penn State Hershey Medical Center

Danny George

on 8 September 2014

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Transcript of Rowan - Dangers and opportunities for social media

Dangers and opportunities for social media in medicine

The reality
Learning objectives

1) Identify the dangers of social media in medicine

2) Examine ethical issues emerging from physician use of social media

3) Discuss strategies for integrating social media into modern healthcare
Daniel R. George
Department of Humanities
Penn State College of Medicine

Divergent "cultures"
of social media and medicine
Dissection of violations
What are medical boards on the lookout for?
Dangers of social media in medicine
>90% of medical students
are on Facebook or
other social networks
~Bosslet et al (2011)
Journal of General Internal Medicine
Information management and professional networking
Direct communication with patients :/
Public health tool
Thought leadership
-Sharing expertise
-Interpreting research and guidelines
-Provoking discussion
-Countering misinformation
-Sharing stories, finding joy in job
-Widening sphere of influence
Hospital communication with the general public
Resources for patients
Cloud-based word processing application
Fosters real-time collaboration
Means of facilitating dialogue during lectures
Value of anonymity
personalized news and research
Opportunities for social media in medicine
After watching a young child in the PICU take her final breath, the 29-year old resident exited the room where she privately grieved before pulling out her smart phone. Opening her Facebook app as the tears flowed, she typed a short, cathartic status update that was instantly published to her network of hundreds of friends: “An angel has a new pair of wings”.

During the next 24 hours, over 40 responses were posted beneath the resident’s original thread, with friends and family from around the world comforting her for having witnessed the child’s death. Eventually, the child’s parents – from whom the resident had previously accepted a Facebook friend request – also commented, thanking their doctor for her compassion and posting funeral information for their child. Realizing that the innocent status update had become a vessel for identifiable patient information, the resident promptly deleted the post.
-26-year old pt requests prophylactic bilateral mastectomy w/ reconstruction
-Reported developing melanoma at 25, mother/sister/cousin w/ breast cancer
-Brother treated for esophageal cancer at 15
-Members of treating team are skeptical and cannot find documentation of reported melanoma
-Surgeon calls PCP, unable to substantiate patients claims, identify other inconsistencies; surgeon learns that pt has seen 2 other surgeons
-Surgeon asks genetic counselor "Am I on firm ground to do a bilateral mastectomy?"
-The genetic counselor "googles" the patient
-She finds 2 Facebook pages, one stating that the pt had been diagnosed with breast cancer, the other soliciting donations for a young cancer survivor summit and including pics of pt w/ bald head as if she has been through chemo
-Genetic counselor shares Facebook pages with surgeon who decides not to operate

Should healthcare professionals "google" their patients?
I have nothing to disclose
Modahl M, Tompsett L, Moorhead T. Doctors, Patients & Social Media. 2011.
Danny George
-Need for qualitative accounts of successful social networking strategies
-What are the most effective networks?
-How can networks be optimized amongst diverse groups?
-Can social media lead to:
-fewer hospitals visits / re-admissions
-improvements on vital sign
-lower health care costs
-increased patient satisfaction scores
PSCOM+ Stress Management Group
Active learning during lectures
Case studies
Social and Mobile phone Activation in a Risk-Reduction trial: The SMART study
Participants posting about HIV prevention and testing were significantly more likely to request an HIV testing kit.
1 in 10 use social networks to screen applicants
Over half feel unprofessional information could compromise admission
Internet-based applications that allow the real-time creation and dissemination of user-generated content
“Since then in my job, I’ve had to learn to look at death, in all its horrible manifestations, and not take pause. But I still find myself wishing for another chance to respond to that casual online message. To say: “Hey, what’s up? I’m sorry it took me so long to get back to you. You’re O.K. to stop humming now.” Dr. Daniela Lamas
Know your institutional policies
Be mindful of HIPAA/PHI
Stay apprised of privacy settings
Monitor your online presence (Google yourself)
Develop disclosure/conflict of interest statement
Establish comfortable boundaries with the public
Distinguish what is acceptable online chatter (general medical news/tips) vs. what is not (direct Dx & Tx)
Don’t reject social media without giving it a fair chance
Precautions for users
Case of deceptive mastectomy
Angel in the PICU
Online state donor registries experienced a
23-fold surge
in donor pledges within one week of the feature being rolled out, according to Donate Life America
“Facebook’s current privacy settings make it simple and easy to maintain communication with a patient without “friending” them, or to have them as a "friend" while granting them no access to your non-professional content.”
“[Patients] might be more uninhibited with information when not face-to-face and more likely to share pertinent information on Facebook; they might feel more comfortable with the physician and view them as more of a person with whom that they can speak candidly and honestly instead of telling them what they think the physician wants to hear. [With Facebook], you can glimpse into a patient’s personal life and have a better understanding. For example, if [you] notice several posts about being depressed or other similar feelings, you may be able to talk about it during the patient's next visit.”
Quality of information
Policing of the site
Physician presence
Generational differences
Building networks of colleagues
"Blood pressure, lipids & BMI"
Medical Education
Professional development
Managing reputation
Study recruitment
Patient Centered Medical Home Group
Practice Management Curriculum for Residents
New employee social media orientation
Interdisciplinary training workshops & junior faculty development programs (CME)
Compensation for faculty using social media for patient education/recruitment :)
Promotion and tenure
"We must extend our care of the community into the community, understanding the upstream determinants of downstream sickness. This effort might include advocating for the local farmer's market to accept food stamps, organizing walking clubs for physical exercise, and lobbying both to reduce emissions to improve air quality and to increase public health funding for the fight against childhood obesity."

Extending care into the community
Improving communication with patients and families
Educating patients about healthy lifestyles
Fostering team-based preventive care
Improving outcomes and reducing costs
Physicians & social media: It's Complicated
Within medicine, does social media have a role in
enhancing patient-physician interactions
fostering greater exchange of health information
improving outcomes across health systems
reducing costs
contributing to professional growth and development

Full transcript