Dr. McDreamy to the OR, stat: There's a strange new virus infecting the medical staff at Seattle Grace that could have broad ramifications for health insurance and health care reform. The virus spreads quickly, has few precedents in modern medicine, and continues to baffle our best and brightest physicians. Its street name? Social media.
At the very moment when the guidelines issued under the Health Insurance Portability and Accountability Act, or HIPAA, have responded to the computer age by slapping a tourniquet on the free flow of sensitive patient information online, the explosion of social media has opened up myriad digital incisions through which vital patient information might leak.
The health insurance and medical communities have been at the forefront of harnessing the power of the Internet and intranets to exchange voluminous and time-critical patient information quickly. A most welcome secondary benefit of the so-called Health 2.0 movement is cost savings.
The Department of Veterans Affairs estimates that its VistA health care system, which allows doctors to communicate online with the system's 3 million patients, has cut its per-patient cost by 30 percent. The Obama administration, citing a RAND study, estimates that just the electronic records provisions of its health care reform could save more than $60 billion annually. Where the exchange of health insurance or medical information between health care providers and with patients is concerned, faster is clearly better, perhaps even life-and-death better.
But what has hospital risk managers worried, and legions of malpractice lawyers salivating, are the potential downsides to all this digital doctoring.
Forward-thinking doctors who already tweet, post blogs and host perfectly HIPAA-compliant MySpace and Facebook sites claim social media is imperative for a healthy practice. Among the benefits, it helps a physician spread the word about their practice, philosophy and approach to care, put a human face on an often faceless profession, manage their reputation online, and contribute to medical education. They point as well to social media's potential to quickly disseminate news of outbreaks such as SARS. Proponents even claim that the online interaction with patients can make a physician a better doctor.
The reason your doctor may not have "friended" you to date is, the health care and health insurance industries are fundamentally cautious by nature and steer well clear of even the perception of treating patient information frivolously. No health care employee wants to be perceived as frittering away office time on Twitter or Facebook with a waiting room full of sick patients in need of care.
Doctors, as a subphylum, are equally uncomfortable with the protocols (read: potential landmines) of social media. Ditto their lawyers, who have likely advised them that the directions to hell are scrawled on Facebook walls. Could a physician be held accountable for actions they take or fail to take as a result of information about a patient acquired online? There's not a lot of court precedent yet, but it's quite likely that what you tweet and post to MySpace and Facebook could and would be used against you in a court of law someday.
What's your diagnosis? Should doctors be involved in social media? Would you "friend" your doctor? Would you be comfortable if your doctor "friended" you?
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