As we are about to enter a new decade of our not-so-new Millenium, we are coming to terms with the speed and the ever-changing landscape of how communication technologies are transforming many areas of our lives, including legal.

We have written a few blogs on social media and its implications in litigation - Social Media and Authenticity, and Elements of Social Media in Discovery. However, in this post, we want to explore three ethical considerations in the complex marriage between Social Media and Health Care. Here, the definition of social media here encompasses internet-based tools and applications that are used to share and distribute information.

With the increase of social media usage and its influence in individual health care; social media is attracting the attention of researchers, clinicians, and other healthcare organizations, but that’s not without risks. In many cases, information shared on social media may involve high levels of self-disclosure by patients and their healthcare experiences, while physicians may also experience adverse outcomes through unintentionally sharing sensitive and private information about patients. Both patients and healthcare providers can fall prey to a lack of understanding and knowledge of the complexities of using social media.

Of course, not all is negative in the realm of social media. Social media platforms can serve as real-time learning resources for both healthcare professionals and patients. It can help provide awareness, promote health, provide peer support, and bring a whole new dimension to community and learning to healthcare. Nevertheless, used without care, it can pose dangers for both patients and healthcare professionals.

Ethical issues concerning social media and healthcare are multi-layered and complicated as more healthcare providers are making more use of social media. From the perspective of law, the changing landscape of data protection, and possible usage in litigation, we want to explore these three ethical issues.

Patient-doctor communication through social media

Communication between physician and patient is strongly characterized by confidentiality, trust, and privacy, as the data exchanged is expected to be safely stored in the patient record. Many guidelines clarifying the patient-doctor communications through email, web-based forms, as it pertains to confidentiality, unauthorized access, and privacy risks are necessary and need to be updated continuously.

Healthcare professionals need to be familiar and cautious about the privacy provisions for each social media platform, as they and their content are protected. This helps in creating a clear division between their personal and professional lives and keeping it from view from their patients. Also, digitally tracking a patient’s behavior can threaten the relationship of trust and confidentiality between patient and physician.

Ethically, physicians must use care and good judgment when it comes to maintaining the proper level of professional relationship and confidentiality when navigating the online space. Other electronic means of communication may be helpful, but are not to substitute face-to-face appointments. The ambiguity of the written language without the context of body language from a face-to-face encounter can lead to problematic issues down the line, with an accompanying paper trail.

Social Media and Electronic Health Records (EHRs)

The very basis of the patient-physician interaction is rooted in protecting and safeguarding the confidentiality of the data exchanged. This is both an ethical and legal requirement as outlined by the Health Information Portability and Accountability Act (HIPAA.)

Health organizations and providers need to be aware of how to collect and secure the data that is generated in the use of social media in clinical environments as a source of health information. Patients will also need to be informed and educated on what is protected as personal health information and what isn’t. Patients will need to be taught with transparency and clarity on how to appropriately use social media platforms when interacting with health professionals, while health professionals will also need to receive specific training on how to appropriately use social media platforms.

When it comes to social media and health care, ethical considerations should be at the forefront of the development and improvement of this potent space for dialogue between patients and healthcare providers.

Privacy of data and wearable technologies

Wearable technologies are a rising medical gadget that has surged in previous years and is predicted to continue to grow. However, the personal data generated from wearables poses many ethical and privacy of data concerns.

Currently, there are three different types of wearables: fitness trackers, sophisticated devices, and applications (i.e., application for mobile devices to assist individuals with the maintenance of diabetes, or emphysema, or congestive heart failure.) These technologies often come together with smartphones/watches and require third party applications, which can then pose threats of a data breach. The more third parties that are involved in the mix, the more challenging it is to keep things secure.

While the accessibility of wireless technology around the world is making wearables more attractive and helpful, it also increases the risk of information leaks that individuals would want to keep secure. All of this leads to further concerns around access rights, security, and privacy of the data collected through wearables that provide more than your health data but also include your location and activity.

The ethical question at the core of how to best make use of wearables is if we want the data obtained from our wearables to serve as the guide in how we make health decisions. For that question to be answered, the users will need to be reassured that first and foremost, the companies developing these wearables have their data security at the top of their list as they develop further iterations of these devices.

What's next?

The triad of social media, healthcare, and technology dazzles with the allure of possibilities and positive potentials. However, ethical considerations around data privacy and proper education of both patients/users and physicians/healthcare providers should be at the top of the list of concerns.

As a culture, we have been seduced by what technology and its speed can afford us, but as we are about to start a new decade, we are becoming increasingly aware of how much of our privacy has been taken for granted. This is the space where much of our legal, cultural, and social discussions will take place in the next decade -- the boundary between our privacy and what we choose to allow to be made public about our lives.