what happens online · social media –personal concerns •usage on your personal social media...

What happens

online stays…

ONLINE

Disclaimer: The views and opinions expressed in this presentation are solely those of the author

PSIC does not set practice standards

We offer this only to educate and inform

Disclaimer

Copyright 2017 - NCMIC Insurance Company

Social Media

Professional/Personal Pitfalls

Healthcare

Real Examples

Employees/Employers

What is Social Media?

Information, opinions or visual imagery created,

shared, exchanged or “liked” through virtual

communities, networks and sites.


http://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwis-ZiVx5_SAhWpy4MKHTfyAbcQjRwIBw&url=http://www.howardluksmd.com/orthopedic-social-media/your-healthcare-digital-footprint-101/&bvm=bv.147448319,d.amc&psig=AFQjCNHK-vxptGP896DOwGTxbmAG1afE2w&ust=1487709511311957

The Numbers

• 2016, 2.3 Billion active SM users

• 65% of American adults use SM sites

• 500 Million tweets per day, 6000 tweets every second

• 2015, $8.3 Billion generated from social networking advertising

The Numbers and Facebook

• 8 in 10 Americans use Facebook

• 76% of Facebook users visit the site daily; 55% visit multiple times per day

• 93% of Twitter users also use Facebook

• 95% of Instagram users also use Facebook

• 92% of Pinterest users also use Facebook

The Statistics

Facebook 2016

• Announced 1.79 billion total number of active users world

wide. (Statistic Brain)

• Every 60 seconds 510k comments are posted, 293k

statuses are updated, and 136k photos are uploaded.

Twitter 2016

• 1.3B accounts.

• 500M tweets sent each day (6000/sec!)


The StatisticsInstagram 2016

• 400M active users. • 3.5B likes everyday. • 80M photos shared per day on average.

YouTube 2016

• 1.3 billion users• 300 hours of video content are uploaded every minute• Nearly 5 billion videos are watched every single day• More content is uploaded to YouTube in 30 days than all three major TV

networks combined have created in 30 years!


http://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjwq8ODm6zTAhUZ3YMKHbjhCz4QjRwIBw&url=http://www.minerals.net/&psig=AFQjCNEHC7KY-JlZsr-KrUNpN2d06iE2dA&ust=1492543194161055

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&ved=0ahUKEwjFzsWVm6zTAhVK5IMKHeuOAOcQjRwIBw&url=https://www.youtube.com/yt/brand/downloads.html&psig=AFQjCNHOE1_fEx196_VCWlpq6acurIE29Q&ust=1492543285587070

What Doctors Are Doing?

• Doctors, like patients, utilize social media in various ways

too.• A desire to gain medical knowledge from peers

• Forums to discuss cases with peer community

• Promote better health among public

• Marketing & Branding opportunities• Staying in front of patients and potential patients by actively utilizing

social media – providing links, information, blogs, etc.

• Build an online identity sharing information (limited) about

themselves, their practice, etc.


• Doctors generally receive little to no training on how to effectively utilize and deal with social media within their formal education.

• JAMA Study 2009

• George Washington University and Johns Hopkins University

• Findings

– 78 medical schools responded; 60% reported violations of patient confidentiality, profanity, discriminatory language, depiction of intoxication or illicit substance use, sexually suggestive material and neg comments about

Doctor’s Training?


• Further Outcome from Study:

• 62% of medical schools have no

professionalism policy for student posting

online content

• 11% of Deans stated they were developing

policies

• 50% said they were going to update existing

policies

Healthcare Usage


• Hospital Usage is on the Rise!!

• As of 2013 (Ed Bennett Hospital Social Networking List)

– 716 You Tube channels (compared to 398 in August 2010)

– 1292 Facebook pages (compared to 631 in August 2010)

– 998 Twitter accounts (compared to 634 in October 2010)

– 209 Blogs (compared to 87 in August 2010)

– Patients now can stay informed, have more control over their own healthcare and

learn from experts at their own pace

Healthcare Usage

Copyright 2014 - NCMIC Group, Inc.Copyright 2017 - NCMIC Insurance Company

Why is Social Media Effective

9 out of 10 people don’t trust advertising

8 out of 10 trust recommendations from people they know

Why Does Social Media Matter?

• More than 40% of consumers say that information found

on social media affects the way they deal with their

health. (Source: Mediabistro)

• 90% of respondents from 18-24 years old said they would

trust medical information shared by others on their social

media networks. (Source: Search Engine Watch)

• 41% of people said that social media would affect their

choice of a specific doctor, hospital or medical facility. (Source: Demi & Cooper Advertising and DC Interactive Group)


• Of the 74% of adults who use the internet;

– 80% of internet users have looked online for

information about health related topics

– 34% of internet users, or 25% of adults, have

read someone else’s commentary or experience

about health or medical issues on an online

news group, website, or blog

– 24% of internet users, or 18% of adults, have

consulted online reviews of particular drugs or

other healthcare treatments

Why does Social Media Matter


Professional Pitfalls

Communication Styles

HIPAA violations

Professional profiles

Friend-ing patients

Medical advice

Healthcare relationships

• Face to Face –

– Can see, hear, perceive

– Careful about the volume and nature of the

information disclosed – aware of audience

• Internet –

– Not able to hear tone/voice inflections

– Cannot see body language & non-verbal

communication

– Not so careful. Lack of awareness or

obliviousness about who will view. Millions of

unknown users may stumble upon the

Communication Style


• Presenting material clearly in person, reacting to them in clinic

personally and being available for discussion

• Using social media cannot replace YOU!

Technology Secondary to Face/Face


HIPAA

• HHS reports that the majority of HIPAA violations from

recent years have occurred from employees mishandling

PHI – many from the misuse or inappropriate social media

sharing.

• HIPAA civil penalties can range in fines from $100 -

$1,500,000

• Criminal penalties can also be assessed resulting in fines

from up to $250,000 and 10 years in prison.

• Loss of license or termination of employment are also

consequences that could be faced.


HIPAA


• Posted to Facebook: CA 60 year old male stabbed 16 times in the neck by nursing home roommate. EMS and ER personnel posted the photos.

• Cawley-Jean, N. Why is it so hard for hospital staff to follow HIPAA rules when using social media? August12, 2010

HIPAA Violation


• November 2nd, 2011

• Psychiatrist on trial for disclosing PHI without

authorization

• Patient treated by psychiatrist

• Patient complains about psychiatrist

• Psychiatrist finds out and tells her employer

to put her on a “psychiatric hold”

Virginia Federal Prosecution


• Certified nursing assistant took a picture of

a paraplegic patient in a compromising

position

• CNA says to her co-worker; “This is too funny.

I need to take a picture of this”

• Coworker: “Please don’t take the picture.

Coworker notices picture on Facebook wall.

Reports to employer (as required under

HIPAA/HITECH)

• CNA fired, arrested and facing voyeurism

charges

Indiana Federal Prosecution


• December 2009

• Governor Tweeted: “Glad the Legislature

recognizes our dire fiscal situation. Look

forward to hearing their ideas on how to trim

expenses”

• RN tweeted back: “Schedule regular

medical exams like everyone else instead of

paying UMC employees overtime to do it

when clinics are usually closed”

• RN indirectly referenced PHI

State of Mississippi


Personal Pitfalls

YOUR DIGITAL FOOTPRINT IS

WIDE AND ALWAYS

LEFT BEHIND

Personal Pitfalls

– Pictures

– Political Views

– Cultural/Religious Views

– Opinions

– Posts, articles, pictures that damage your

credibility as a professional

– Personal issues, arguments, rants


Patient Communication – Personal Concerns


Employees and Social Media

They are cognizant of the

vulnerability of their reputations

on digital media

but are unwilling to sacrifice

internet participation

Social Media – Personal Concerns• Usage on your personal social media accounts

will always reflect upon your professional title.

• You are always known as or associated with

your job/career/employer

• Posts, tweets, pictures, video, etc., may not

only have an impact upon you and your

character, but the perception of the

profession.

• The public can have a tendency to attribute

certain traits and behaviors to an entire group

based upon the actions of one.Copyright 2017 - NCMIC Insurance Company

Employee Pitfalls

and

Employer Techniques


Patient Communication: Social Media & Employment


• Employers increasingly using job applicants social networking profiles to supplement job applications

– 2010 study reported that 75% of recruiters used the internet as part of their applicant screening process (Walker).

• Individuals see “junk” as a joke to be only viewed by “friends”, prospective employers are another story

• Employers need to tread carefully if making an employment decision based on “profiles”

– Should have a neutral third party (other than the hiring party) screen the profiles of the candidates. They should be trained in what to look for and convey back to hiring party. They should also be trained in what not to report back to hiring party so they are avoiding information that could trigger laws in place.

Employer Advantages/Risks


• Almost 30% of job applicants denied

employment when potential employers

discovered information about them posted

over the internet

– Parker K.: “Web Warning for Youths: Employers

are Watching” Real Clear Politics, March 9th,

2007.

• Employee posts – In personal use of social

media, employees can post information that

prompts disciplinary action

“Employers are Watching”


• Once you send/post you can’t

UNSEND/POST

– If it’s posted on the internet, consider it

permanent – even if you delete posts, emails,

picures, etc.

– You may limit it to an audience with your privacy

settings, but that doesn’t mean your audience

won’t share, repost, or even copy and save

(screen cap).

– WayBackMachine – http://archive.org

• Internet archive with over 402 billion webpages saved

– All attorneys are aware this site exists and use it

Problem?


http://archive.org/

Malpractice Cases


Before and After and Texting

https://www.bing.com/images/search?q=young+man+running+images&id=98C0338E318D7CEB7EB3CF976342C67F76787A98&FORM=IQFRBA

https://www.bing.com/images/search?q=before+and+after+pictures+of+icu+patients&id=F26655813C19D246DE7CB910D9B7EC3BB4FB736A&FORM=IQFRBA

Facial Nerve Injury Case

Patient alleges poor informed consent leading to

nerve injury

Complaints of facial sensitivity to hot/cold,

drooling, pain upon drinking

https://www.bing.com/images/search?q=images+of+a+woman+drinking+beer+on+a+lake&id=C9010853AF5DA9AAA431291B031FF494294CAE35&FORM=IQFRBA

Employee and Social Media

• Currently on the lookout for a lost old person

#NursingHomeProbz

• Today we had a terrible fall with a serious

head injury and lots of blood. Calls for

subway and some beers. ray@rachelm93

• Sucking down coffee like its my job in order

to function for this 8hr shift I am working…by

myself. erinm@eske7

Public Awareness

• Nursing Home case

• Juror problems case

• Hospital case

Example #2:Patient comes back to clinic to photograph for lawsuit

Avoiding Pitfalls

1. Social Media policy

2. Maintain privacy on public and private channels

3. Consequences!

•You need to have something in place!

•To protect your patients’ rights

•To instill professionalism throughout your

enterprise

•To protect you and your organization from liability

•To protect your employees from liability

Social Media Policy


• If the doctor or organization does not know

that employees are posting PHI but knows of

the popularity of social networking websites

and that its employees use such websites;

• Under Proposed HIPAA changes – may be “willful

neglect” if no policies and procedures are in place

• In the HIPAA proposed rule, HHS focused on lack of

policies and procedures

Why have the Social Media Policy?


• http://sharing.mayoclinic.org/guidelines/for-

mayo-clinic-employees/

• https://ww2.mc.vanderbilt.edu/socialmediat

oolkit/26838

• http://socialmediagovernance.com/policies/

(this site has 251 policies available)

Policy Examples


http://mc.vanderbilt.edu/root/vumc.php?site=socialmediatoolkit

http://socialmediagovernance.com/policies.php

http://socialmediagovernance.com/policies/

• Check your privacy settings on social networks

• Remember doctors are held to higher standards of

personal conduct than other groups in society

• Malpractice allegation? Don’t talk about it on a

social networking site. Remember any social

networking site can be used against you in any

litigation and displayed on a large screen before a

jury in court.

Recommendations



http://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwis-ZiVx5_SAhWpy4MKHTfyAbcQjRwIBw&url=http://www.howardluksmd.com/orthopedic-social-media/your-healthcare-digital-footprint-101/&bvm=bv.147448319,d.amc&psig=AFQjCNHK-vxptGP896DOwGTxbmAG1afE2w&ust=1487709511311957

In case of FIRE …

EXIT building

before

posting it on

Social Media

https://www.bing.com/images/search?q=images+of+fire+escape+signs&id=926B2FC0272ABDA7AA59144928515CC25BEDB2ED&FORM=IQFRBA

QUESTIONS?

Thank you for attending

today’s risk management

seminar

Please visit www.psicinsurance.com

for additional risk management

offerings and information.

If you have questions or comments

please contact PSIC’s risk management division

at (888) 336-2642 or email us at

[email protected]

Thank you!

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