docMedicolegal Risks with Social Media
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Medicolegal Risks with Social Media
10/23/2015 Faculty / Presenter Disclosure Faculty: Employee of: Think Before You Click Medical legal risks associated with Social Media Dr Nuth CMPA Relationships with commercial interests: None - Grants / Research Support: ________________________ - Speakers Bureau / Honoraria: ________________________ - Consulting Fees: ________________________ - Other: ________________________ Conflict of Interest - I have no financial or professional affiliation with any organization that can be perceived as a conflict of interest in the context of this presentation. Associate Professor Dept of Emergency Medicine, University of Ottawa Copyright - Not to be distributed without written permission of CMPA. No audio recording, video recording, or photography is allowed without CMPA's permission. Information is for general educational purposes only and is not intended to provide specific professional medical or legal advice or constitute a “standard of care”. CSIM, PEI, Oct 16, 2015 Media Asset Copyright - All non-CMPA audiovisual files are used with permission and for educational purposes only. All rights belong to the original owner as per license agreements – Thinkstock, YouTube and others as required. Dr Janet Nuth, Physician Risk Manager CMPA © The Canadian Medical Protective Association cmpa-acpm.ca By the End of This Session, You Will Be Able to: © The Canadian Medical Protective Association cmpa-acpm.ca Growing Up with Social Media • Summarize the medico-legal risks that must be considered when using social media • Outline the best practices regarding the use of social media in your learning and practice. © The Canadian Medical Protective Association cmpa-acpm.ca © The Canadian Medical Protective Association cmpa-acpm.ca 1 10/23/2015 Social Media © The Canadian Medical Protective Association cmpa-acpm.ca Professional networking © The Canadian Medical Protective Association Medical Education Over © The Canadian Medical Protective Association cmpa-acpm.ca cmpa-acpm.ca 5,000 tweets in 2014 conference © The Canadian Medical Protective Association cmpa-acpm.ca 2 10/23/2015 Advocacy © The Canadian Medical Protective Association Practice Management cmpa-acpm.ca © The Canadian Medical Protective Association cmpa-acpm.ca cmpa-acpm.ca © The Canadian Medical Protective Association cmpa-acpm.ca Health engagement © The Canadian Medical Protective Association 3 10/23/2015 What issues with social media are seen in CMPA cases? Professionalism © The Canadian Medical Protective Association cmpa-acpm.ca Digital Footprint © The Canadian Medical Protective Association cmpa-acpm.ca What if this was your doctor? Oh my dear Thanks to Juli – what a crazy night! for this memento! The « you’re going to regret it » button © The Canadian Medical Protective Association cmpa-acpm.ca © The Canadian Medical Protective Association cmpa-acpm.ca 4 10/23/2015 When was the last time you reviewed your privacy settings on Facebook? © The Canadian Medical Protective Association cmpa-acpm.ca Ottawa FPs on Facebook © The Canadian Medical Protective Association cmpa-acpm.ca Can I friend a patient? • 10% had publicly viewable profiles • 81% had visible profile photo • 91% could be messaged directly by member of the public • Majority shared limited personal info A slippery slope for professional boundaries [Premji Br J Med Medical Research 2014] © The Canadian Medical Protective Association cmpa-acpm.ca © The Canadian Medical Protective Association cmpa-acpm.ca 5 10/23/2015 Status Updates? • “Worst preceptor ever…” • “The charge nurse is such a…” • “Saw the fattest patient in clinic today…” Boundary Violations Personal Site/ Professional Site © The Canadian Medical Protective Association cmpa-acpm.ca © The Canadian Medical Protective Association cmpa-acpm.ca © The Canadian Medical Protective Association cmpa-acpm.ca Commentary on article: Medical acronyms What would your patient think? © The Canadian Medical Protective Association cmpa-acpm.ca 6 10/23/2015 If you wouldn’t say it in a crowded elevator, don’t write it online Don’t discuss patients Don’t rant about colleagues Don’t let your fingers type what your mouth wouldn’t dare say © The Canadian Medical Protective Association cmpa-acpm.ca Professionalism cmpa-acpm.ca Take Home Messages • • • • Understand your audience Be respectful and transparent Your views vs. hospital/organization Permission & acknowledgement of posting material created by others • Avoid 1 to 1 medical advice in public forums • Terms of use agreements for websites © The Canadian Medical Protective Association © The Canadian Medical Protective Association cmpa-acpm.ca Professionalism Digital Footprint © The Canadian Medical Protective Association cmpa-acpm.ca 7 10/23/2015 A Physician , a Cell Phone… and a Lack of Judgment The best of intentions… Is it okay to post without mentioning the patient’s name? © The Canadian Medical Protective Association cmpa-acpm.ca © The Canadian Medical Protective Association cmpa-acpm.ca © The Canadian Medical Protective Association cmpa-acpm.ca Hey! That’s My Belly Button Ring! © The Canadian Medical Protective Association cmpa-acpm.ca 8 10/23/2015 Once It’s Out There, It’s Gone… • For all intents and purposes – Although password-protected – Despite personalized settings – Despite restricted access Consider social media to be public spaces © The Canadian Medical Protective Association cmpa-acpm.ca BC College cmpa-acpm.ca Take Home Messages In light of these serious allegations, the College is reminding all registrants that photographs of patients may only be taken for legitimate purposes (clinical, research, teaching, quality control) and only with the informed consent of the patient. Further, photographs may not be distributed to colleagues or published on social media sites (blogs, online forums, etc.) without the expressed consent of the patient. © The Canadian Medical Protective Association © The Canadian Medical Protective Association cmpa-acpm.ca Professionalism Digital Footprint © The Canadian Medical Protective Association cmpa-acpm.ca 9 10/23/2015 Blog post came up when family searched Dr’s name. Family member initiates a College complaint about MD’s poor communication with patient Dr. XXXX These f***nurses in _____. SOOOOO useless !!!!! DON’T come here to work. I’m looking in----------- for a new position. Forwarded to College along with complaint letter © The Canadian Medical Protective Association cmpa-acpm.ca Consultations Then and Now © The Canadian Medical Protective Association cmpa-acpm.ca © The Canadian Medical Protective Association cmpa-acpm.ca Why use email/texts? © The Canadian Medical Protective Association cmpa-acpm.ca 10 10/23/2015 Smartphones and Patient Care • 70% of residents and 45% of faculty reported texting students about patient care – More efficient than meeting in person or phoning • < 10% used devices to transmit or view clinical data or images relating to patients • ~ 50% described taking pictures of patients Only one-third felt there were privacy issues © The Canadian Medical Protective Association cmpa-acpm.ca Email Auto-population © The Canadian Medical Protective Association cmpa-acpm.ca © The Canadian Medical Protective Association cmpa-acpm.ca Texting Handovers? © The Canadian Medical Protective Association cmpa-acpm.ca 11 10/23/2015 Do you have patient personal health information on a mobile device? Dangers of Texting Insecure method of communication Cannot verify identity of sender Messages not maintained in medical record Informality of communication Auto-correct functions © The Canadian Medical Protective Association cmpa-acpm.ca © The Canadian Medical Protective Association cmpa-acpm.ca cmpa-acpm.ca © The Canadian Medical Protective Association cmpa-acpm.ca Think Encryption © The Canadian Medical Protective Association 12 10/23/2015 Email/Text with patients • • • • • • • What will be communicated to patients How emails will be handled Auto-reply messages Consent (written or oral) How you will document Policy on sensitive topics Educate staff and others © The Canadian Medical Protective Association cmpa-acpm.ca MD-pt electronic communication consent- CMPA © The Canadian Medical Protective Association cmpa-acpm.ca © The Canadian Medical Protective Association cmpa-acpm.ca Distracted doctoring © The Canadian Medical Protective Association cmpa-acpm.ca 13 10/23/2015 Social Media Take Home Messages Professionalism © The Canadian Medical Protective Association cmpa-acpm.ca Key Messages cmpa-acpm.ca Social Media – Do’s and Don’ts • All information posted on social media sites should be assumed to be in the public domain • The same high professional standards for physicians apply online • Assume that all online information is discoverable © The Canadian Medical Protective Association Digital Footprint © The Canadian Medical Protective Association cmpa-acpm.ca Do: • Be mindful of your online persona • Be proactive in removing potentially unprofessional content posted by friends • Be aware of how online posts may reflect negatively on medical professionalism © The Canadian Medical Protective Association cmpa-acpm.ca 14 10/23/2015 Social Media – Do’s and Don’ts Do: • Opt for highest privacy settings • Encrypt and password protect mobile devices • Obtain expressed consent – for distributing/ posting personal health information – email/texting communication with patients © The Canadian Medical Protective Association cmpa-acpm.ca Social Media – Do’s and Don’ts Don’t: • Underestimate the risk of violating patient privacy, even in de-identified posts • Establish personal connections with patients online • Seek information about patients online without obtaining prior consent • Provide one-one medical advice in a open online forum © The Canadian Medical Protective Association cmpa-acpm.ca Physician Websites-CMPA © The Canadian Medical Protective Association cmpa-acpm.ca © The Canadian Medical Protective Association cmpa-acpm.ca 15 10/23/2015 No Md-pt relationship, no endorsements, laws of Canada © The Canadian Medical Protective Association cmpa-acpm.ca GPG – Professionalism © The Canadian Medical Protective Association cmpa-acpm.ca CMPA Risk Management Education 1-800-267-6522 @cmpamembers © The Canadian Medical Protective Association cmpa-acpm.ca 16