New technologies such as smartphones and social media are both an advantage and a disadvantage in healthcare. Privacy and confidentiality requirements must be balanced against the new capacity which these tools are able to provide. The Health Insurance Portability and Accountability Act or HIPAA provides a clear legal framework for determining some of these boundaries.
HIPAA regulatory requirements
HIPAA involves regulatory requirements which ensure the privacy and confidentiality of patients in the data driven information age. HIPAA includes provisions that protect electronic medical records and insurance coverage for those with pre-existing conditions, but it also provides guidelines with regard to the information which can be sought or shared by healthcare professionals in support of their duties. This includes the use of smartphones or social media to share or research information. That which is a potential breach of privacy can include many unintended situations, such as texting another healthcare provider about a specific patient and having the smartphone lost or stolen, leaving the information to be found by persons who are not authorized to have that information (Greene, 2012). It can also include posting or otherwise sharing information about a patient which represents a breach of confidentiality. While much of the focus under HIPAA has been ensuring the security of electronic medical records, there are actions which nurses, physicians and other healthcare professionals take every day which must be considered in terms of the potential for non-compliance with HIPAA provisions (Greene, 2012).
Advantages of smartphones and social media
Three advantages of the use of smartphones and social media in healthcare are as a fast reference, rapid means of communication and as a means of facilitating dialogue with regard to specific subjects and research questions in healthcare.
Mosa and colleagues (2012) reviewed a number of applications for smartphones in the academic literature base using MEDLINE to identify journal articles and findings. With regard to smartphone applications which can support professionals in healthcare they found that communications and evidence based practice were the focus of smartphone based tools. Smartphones are being used for diagnostic and pharmaceutical research and reference, for communications with other professionals, patients and system information systems and patient disease management (Mosa et al., 2012). A major feature of the use of smartphones in this manner was that it allowed the healthcare provider to remain mobile and onsite (Mosa et al., 2012).
A third advantage was the facilitation of broader dialogues and conversations between professionals with regard to research questions and niche subjects, which have the capacity to further insights and understandings on specific issues. As many of these happen in forums and other public spaces, it also provides a transparent record of such discussions.
Disadvantages and privacy concerns of modern information technology
Three disadvantages of the use of smartphones and social media in healthcare include the potential for misunderstandings, breach of confidentiality and the capacity to use statements made in writing whether texts or discussions in other contexts, including legal ones.
There are many pitfalls to the use of smartphones in the healthcare context, including small screen size, distorted audio and the quick exchange format which can lead to misunderstanding of content or meaning (Redelmeier & Detsky, 2013). What is potentially dangerous is the use of smartphones to send communications which can be misdirected, shared or breached in terms of security in such a way that confidentiality of a patient’s health and medical information is compromised.
Another potential breach of trust and confidentiality is the use of social media is to use it to investigate a patient’s background (Chretien & Kind, 2013). Patients have a right to privacy from their healthcare provider, including nurses and physicians, and such research can be experienced as an intrusive act.
A further disadvantage of smartphones and social media is the record that it can leave of conversations and discussions. Mistakes which are made in writing, or statements which are taken out of context, can become evidence in cases of negligence or non-compliance of HIPAA regulations.
New technologies, like any tool, must be used properly with consideration for the harm that they can cause and this is particularly true of the use of social media and smartphones in the healthcare setting. While smartphones can provide an excellent way to do research and find references in the moment, and social media can provide a broad base for communication and networking, there is also a need to be very careful regarding what and how information is shared. Information which is incoming is less dangerous, in terms of the potential for compromised information which breaches HIPAA regulations, than outgoing information. To that extent, using one’s smartphone as a tool to check on the latest research, contradictions of a medication or the contact information of a specialist is a fairly safe activity.
Where it becomes dangerous is forgetting the context of healthcare work, and sharing or obtaining information in inappropriate ways that breach the clear guidelines as laid out in HIPAA regulations. An important aspect of approaching new technologies while keeping legal, regulatory and confidentiality in mind is to separate personal and professional use of social media and smartphone communications. Social media and personal communications in general are not the appropriate place to share stories regarding patients or to talk about any subject or issue which could be determined to breach the privacy of a patient or healthcare setting. There is significant potential in the use of new technologies for reaching out and communicating with patients and others, but this requires being well aware of public versus private communications.
- Chretien, K. C., & Kind, T. (2013). Social media and clinical care ethical, professional, and social implications. Circulation, 127(13), 1413-1421.
- Greene, A. H. (2012). HIPAA compliance for clinician texting. Journal of AHIMA, 83(4), 34-36.
- Mosa, A. S. M., Yoo, I., & Sheets, L. (2012). A systematic review of healthcare applications for smartphones. BMC medical informatics and decision making, 12(1), 1.
- Redelmeier, D. A., & Detsky, A. S. (2013). Pitfalls with smartphones in medicine. Journal of general internal medicine, 28(10), 1260.