Will social networking kill healthcare privacy?

Robert Scoble has an interesting conversation going on his blog looking at what happens to healthcare privacy as social networking moves into the medical arena (make sure you read the comments).

Scoble’s take on it is that the benefits of social networking and getting the  crowds feedback on your condition, your physician and your prescriptions. I think it comes back to personal choice– if you choose to release your healthcare information, then you are free to accept the benefits and the consequences.

Doctors need for etiquette counts online, too

The New York Times ran a couple of articles at the first of December illustrating the need for doctors to behave appropriately and listing the six habits of highly respectful physicians. Although neither of these articles mention online communications, I believe some paralells can be drawn as to how doctors should communicate with patients online.

First, I think it’s important to acknowledge the role that electronic health records and secure messaging between physicians and patients can have to improve the doctor patient relationship and the patients overall health.  In the next five years we are going to see more and more doctor-patient communication move online and hopefully see more health care team communication move online (think of a facebook like social network all about your health where your nurses, primary care docs, pharmacists, specialists and you can all keep each other up to date about your health).

In this new era it will be important for your doctor and your health care team to exercise appropriate online etiquette to maximize their relationships with you and each other.  Here are some online etiquette tips that a doctor should follow:

  1. Respond quickly  to patients online questions. Tell your patient you or a member of your team will respond within XX hours (24 or less hopefully) and have a work flow set-up to ensure that you meet that goal.
  2. Respond fully to patients online. Take the time to write in complete sentences in language that your patients will understand. In my day to day work i communicate with some doctors over email who reply to me over email in cryptic short bursts of information which if I didn’t know better would leave me thinking they were upset, not just overworked.
  3. Check off and share health care alerts with your patients. Have an automated system for sharing troubling health care issues with your patients and information on solving their health care problems.
  4. Prescribe information online.  Just like patients need prescriptions, links to online information can be a great way to inform the patient and let them make informed decisions about their health care.
  5. Confer with other health team members online. Find a way to create a social health care network where specialists, pharmacists and therapists can all communicate online with each other about the patient.

Eventually a form of online etiquette may need to be taught in Continuing Medical Education and in Medical School to help standardize the appropriate way to communicate with your patients online.

NYC paying doctors to convert to EHR

New York Center is paying doctors to convert to electronic health records and subsidizing the cost of implementation. President-elect Obama pledged during his campaign to spend $50 billion over five years on electronic health records. The New York Times gives a good overview with a couple of examples of the advantages of ehr to the doctor, the patient and to the general population (as to why the city is subsidizing the cost).

We know that at these fancy schmancy systems, they can do these things. But here in New York, we’re trying to do this for the storefront in Harlem,” said Dr. Farzad Mostashari, a health department epidemiologist who is spearheading the New York effort. “As of now, about 2 percent of solo and small practices have electronic health records. This is really hard stuff to do. We have boots on the ground.

For the doctor, it helps him quickly review the patients record.

Particularly for less experienced doctors, the system provides what Dr. Jesse Singer, a health department records expert, described as CliffsNotes-style advice on how to handle medical problems based on a patient’s age, sex, ethnic background and medical history. It prompts doctors to provide routine tests and vaccinations, advises them on appropriate treatment and medication for certain conditions, and warns of potentially dangerous drug interactions.

When given access patients can interact with the doctor’s office electronically, too.

They can request appointments electronically, check lab results or chart how well they are doing in, for instance, controlling cholesterol, blood pressure or blood sugar.

Many in the medical world have long chafed at the notion that patients should not see their charts, and city health officials see the interactivity as a potentially powerful tool to push patients to take more responsibility for their well-being. Just seeing a readout of their vitals at various intervals could help, Dr. Singer said.

Social networking for patients

Since I started working at UAMS, I have been paying closer attention to healthcare and medical sites. I ran across an interesting website last night– patientslikeme. Basically it’s a social network for people diagnosed with serious illnesses. The site says

Thousands of patients with ALS/Motor Neuron Disease, Devic’s NMO, HIV, Mood Conditions, Multiple Sclerosis (MS), MSA, Parkinson’s Disease (PD), and PSP use PatientsLikeMe to better manage their overall health, treatments, and symptoms.

It’s truly an amazing concept for an online community where people can share everything from diagnoses and treatments to how their families are handling their condition.