Ann & Natalie’s Compliance Corner
This month, we take a look at privacy considerations with physician blogs. Missed last month’s report on two recent surveys that highlight surprising differences in health care quality among states? Click here.
Web logs, or “blogs,” are online forums that allow a site owner to post his or her thoughts, photos, and writings, and for readers to leave comments. Blogs are becoming an increasingly popular communication tool in many fields, including health care. While blogs may be beneficial, and may even contribute to improving health care, there are also privacy considerations and inherent risks unique to physician and medical disclosures.
The anonymity that blogs offer can create a false sense of security. Blogs, by their nature, offer an outlet to describe and discuss information that often falls into an “ethical gray area” according to critics.
While many physicians discuss broader subjects that appeal to the entire medical community, some focus on their own patients and otherwise electronically compromise privileged information. Discussing patient cases may expose the blogging physician, even when anonymous, to significant risks. Some examples of improper physician blogs include a surgical registrar who was suspended for posting non-identifying pictures of patient ailments on her anonymous blog, which was intended as a learning tool for medical students; another physician had to take down his blog after it was used against him in a malpractice suit.
“Don’t think about the person reading from thousands of miles away. If people in your community could read your blog and put the pieces together and guess...you should be concerned with a lawsuit,” said Kate Borten, president of The Marblehead Group, a Massachusetts-based health care privacy and security consulting group. Borten also noted that although some physicians claim that they receive permission before posting blog entries about a patient, HIPAA requires signed authorization which specifies how information will be used.
Furthermore, patient confidentiality breaches aren’t the only risks associated with the increasing physician blogging trend. Some critics believe that blogging may reflect negatively on the entire medical profession and make patients more resistant to sharing their information. “One of the fundamental aspects of medicine is that patients have to feel free to tell doctors everything,” said Dr. David Stern, who teaches professionalism at the University of Michigan Medical School. “They’re not going to tell us everything if they’re asking themselves when they come in to see their physician, ‘Is my doctor going to blog about me?’”
While there are risks and liabilities associated with medical blogs, they can also be beneficial. One physician designed his blog as a place to go for useful information, with links to reputable health care sites along with his own essays and personal opinions. Proponents of blogging suggest that blog groups may help physicians to better, and more efficiently, serve their patients.
Physicians’ blogs can also provide patients with a chance to become more familiar with their doctor’s mindset – something that is always beneficial according to Nicholas Genes, a New York City emergency physician who publishes a weekly medical blog known as Grand Rounds. Getting to know a physician outside of the office-visit context could make patients feel more at ease with their doctors, and may play a role in helping patients who are searching for a new physician.
Physicians must be conscientious of the risks inherent to health related blogs and take precautions with sensitive information, even when they believe that they are protected under the guise of anonymity. Given the nature of the legal and ethical obligations regarding privacy of health information, anonymity is not absolute and information must be consistently and adequately protected in accordance with relevant regulations.
Disclaimer: The content of Compliance Corner is for general informational purposes only and should not be interpreted as compliance guidance or advice. Consult your compliance advisor or attorney for compliance or legal advice on specific issues related to your practice or compliance program.
