Presentation at Department of Ophthalmology conference, The Medical City 3 May 2017.

1. SOCIAL MEDIA
ETIQUETTE FOR
HEALTHCARE
PROFESSIONALS
IRIS THIELE ISIP TAN MD, MSC
Director, UP Manila Interactive Learning Center
Chief, UP Medical Informatics Unit
Professor, UP College of Medicine
@endocrine_witch

2. Every move
you make
Every step
you take
I’ll be
watching you

3. Pei-Li Teh & Marc Yates (2013)
researchpartnership.com

4. www.pwchealth.com
People are looking at health-related consumer
reviews on social media. (US data)

5. 17% of consumers who use social media for
health-related activities post reviews of
doctors. (US data)
www.pwchealth.com

6. Likelihood of sharing health experiences via social
media about a specific doctor, nurse or healthcare
provider: positive (42%) vs negative (35%) [US data]
www.pwchealth.com

7. www.pwchealth.com
Likelihood of information
found via social media
affects decision to
seek second opinion
from another MD: 45%
choose specific doctor:
41% [US data]

10. WWW.FACEBOOK.COM/ENDOCRINEWITCH

13. https://www.remindercall.com/patients-are-recording-doctors/
Assume that everything you say in any office visit is being
recorded. This will ensure that you choose your words wisely.
If a patient asks to record the office visit, allow them to record
a summary of instructions at the end of the visit.
If you know you are being recorded, ask the patient to repeat
back to you what you’ve said. Correct any misunderstandings
your patient has. This will improve compliance and protect
you from potential issues.

14. Every move
you make
Every step
you take
I’ll be
watching you

15. Social media is a
window through which
we ask people to look.
How big we make the
window is up to us, as
is what we do in front
of the window.
Journal of the American Pharmacists Association Nov/Dec 2013doi: 10.1331/JAPhA.2013.13536

16. To maintain appropriate
professional boundaries
physicians should consider
separating personal
and professional
content online.
“
Photo by Beautiful Revelry
https://flic.kr/p/e2g7oD
“AMA Policy: Professionalism in the Use of Media.”
American Medical Association, 2012 Annual Meeting.
http://www.ama-assn.org/ama/pub/meeting/professionalism-social-media.shtml

17. PERSONAL
FAMILY & FRIENDS ONLY

18. @ENDOCRINE_WITCH
FOR EVERYONE ELSE :)

19. THE BEST WAY TO CONTROL WHAT KINDS OF
INFORMATION OTHERS WILL FIND ABOUT US
ONLINE IS TO PROVIDE QUALITY CONTENT
AND CREATE WELL-DESIGNED
PROFILES OURSELVES.
“
Bertalan Mesko, Social Media in Clinical Practice

20. THIS! http://www.slideshare.net/SidneyEve/academic-branding-36767502

21. DOK BRU
#ParaSaBayan
www.dokbru.endocrine-witch.net

22. THE ENDOCRINE WITCHBrewing Informatics, Endocrinology & Everything Else
www.endocrine-witch.net

23. SLIDESHARE.NET/ISIPTAN
Creative Commons license
Share Alike, Attribution Required, Noncommercial

24. www.getreferralmd.com
53% of physician practices in the US
have a Facebook page.

25. Every move
you make
Every step
you take
I’ll be
watching you

26. SOCIAL MEDIA IS
LIKE A CROWDED
ELEVATOR.
Others can easily
overhear conversations
without the benefit
of context.
Grotty B & Mostaghimi A. Confidentiality
in the Digital Age. BMJ 2014;348:g2943

27. www.healthxph.net/manifesto
I will conduct myself in a
manner worthy of my
profession, even online.
I will not use online
platforms to rant or bash
patients and healthcare
professionals.
#HEALTHXPH

28. Complaining about or
disparaging patients, even
in general terms, does not
advance the dignity of
patients or the profession.
ASHP Statement on Use of Social Media by Pharmacy Professionals (2012)

29. The higher standards of conduct
expected of professionals, even in
personal behavior, apply as well to
their participation in social media.
Acting with
integrity and
conscience
ASHP Statement on Use of Social Media by Pharmacy Professionals (2012)

30. Preceptors and
mentors have a
special responsibility
to model
appropriate practices
ASHP Statement on Use of Social Media by Pharmacy Professionals (2012)

31. www.healthxph.net/manifesto
I will ensure that the
information I post, like or
share is accurate.
#HEALTHXPH

32. www.healthxph.net/manifesto
I will prioritize the
promotion and
advancement of health
rather than of medical
products.
#HEALTHXPH

33. www.healthxph.net/manifesto
I will refrain from posting
information online that
will compromise
patient confidentiality
and privacy.
#HEALTHXPH

34. PRIVACY
CONFIDENTIALITY
About people
About identifiable data
Extension of privacy
Right to be left alone
Limit access to public
Prevent unauthorized access

35. Although patients and providers benefit
from SoMe, the boundaries between
physicians and their patients can become
blurred, putting both parties at risk.
Roupret et al. European Association of Urology (@uroweb)recommendations on
the appropriate use of social media. European Urology 2014;66:628-32

36. EXTENDING PATIENT-MD
RELATIONSHIP ONLINE?
Purpose
Content
Response time
Farnan et al. Online medical professionalism: patient and public relationships: Policy statement from the
American College of Physicians and the Federation of State Medical Boards Ann Intern Med 2013;158:620-7

37. Bosslet et al. The patient-doctor relationship and online social networks:
results of a national survey. J Gen Intern Med 2011;26(10):1168-74
National survey of US medical students,
resident & practicing physicians
n=455
NOT ethically acceptable to interact with
patients for either social (68.3%) or patient
care (68%) on online social networks
79% expressed concerns
about maintaining
patient confidentiality

38. CONFIDENTIALITY
IS THE PILLAR
OF OUR
PROFESSION.
The patient-physician
relationship is built on
trust that enables
patients to share
intimate details.
Grotty B & Mostaghimi A. Confidentiality
in the Digital Age. BMJ 2014;348:g2943

39. AVOID USING SOCIAL MEDIA
FOR DIRECT PATIENT CARE & CONTACT
Unencrypted
Inadvertently accessible to others
Controlled by a third party
Grotty B & Mostaghimi A. Confidentiality
in the Digital Age. BMJ 2014;348:g2943

40. SOCIAL MEDIA TO FACILITATE CONVERSATION
AROUND MATTERS OF PUBLIC HEALTH
OR AVAILABILITY OF SERVICES
rather than matters related to a specific patient
Grotty B & Mostaghimi A. Confidentiality in the Digital Age. BMJ 2014;348:g2943

41. www.facebook.com/EndocrineWitch
GIVE NOTICE TO PATIENTS THAT SOCIAL MEDIA IS
NOT MEANT FOR CLINICAL COMMUNICATION
Monitor. Take conversation offline if sensitive information is posted.
Grotty B & Mostaghimi A. Confidentiality in the Digital Age. BMJ 2014;348:g2943

43. PATIENT IDENTIFIERS
Names
Geographic information
Dates (eg. birth date, admission date,
discharge date, date of death)
Telephone numbers
Fax numbers
Email addresses
Social security numbers
Medical record numbers
Health plan beneficiary numbers
Account numbers
Certificate/license numbers
Vehicle identifiers & serial numbers,
including license plate numbers
Device identifiers and serial numbers
URLs
IP address numbers
Biometric identifiers (eg. finger and voice prints)
Full-face photographic images & any
comparable images
Other unique identifying numbers,
characteristics or codes
Protected health
information
any medical information
about a specific patient
in combination with any
information that could be
used to identify that patient

44. www.healthxph.net/manifesto
I will value the patient’s
dignity & privacy by not
taking selfies, groufies or
videos during encounters
with patients that include
patients’ body parts,
surgical specimens or that
show patients in the
background without their
consent.
#HEALTHXPH

45. Palacios-Gonzalez C. The ethics of clinical photography & social media.
Med Health Care & Philos DOI 10.1007/s11019-014-9580-y
USE OF CLINICAL PHOTOGRAPHY
PRIMARY
For patient care
SECONDARY
For research and
medical education

46. Clinical photography + social media
DOES NOT equal telemedicine.
Palacios-Gonzalez C. The ethics of clinical photography & social media.
Med Health Care & Philos DOI 10.1007/s11019-014-9580-y
Patients do not have adequate information
to give informed consent.
PRIMARY

47. Even if patients recant consent, nearly impossible
to retrieve or delete clinical images.
Palacios-Gonzalez C. The ethics of clinical photography & social media.
Med Health Care & Philos DOI 10.1007/s11019-014-9580-y
Moderate comments to avoid derogatory remarks
about clinical images or patients depicted.
SECONDARY

48. Ensuring public trust while
engaging on social media
platforms
Commitment to
professional responsibilities
Gholami-Kordkheili F, Wild V, Strech D. J Med Internet Res 2013;15(8):e184
Don’t lie. Don’t pry.
Don’t cheat. Can’t delete.
Don’t steal. Don’t reveal.
A 12-word Social Media Policy
Farris Timimi, Mayo Clinic Center for Social Media
If it’s on the Internet, it isn’t private by DonkeyHotey,
https://flic.kr/p/9RYZvc

49. Social Network Response Guide
Vanderbilt University Medical Center
IS THE POST POSITIVE?
Respond using the
considerations below
TRANSPARENCY
Disclose your connection
to UPCM/PGH
TIMELINES
Take time to develop a
thoughtful response.
TONE
Be personable.
SOURCES
Cite official sources
and link.
NO Record and send to
social media team
Is it a complaint about a
negative experience?
YES
Is this your area of
responsibility?
YES
Do you think responding would
be helpful to the poster?
YES
Is the situation resolvable?YES
NO
Contact your manager. Respond.
I am sorry to hear about the situation. I’d like to
help. Email me. Send to social media team.
Respond.
I am sorry to hear about your experience.
We are always looking to improve. Email
details. Send to social media team.
NO Is the post visible to the
general public?
Is the post highly
personal?
YES
YES
Do not respond.
Record.
YES
NO
NO
Are any of the
facts wrong?
YES Record and
monitor.
NO
Is it a rant or on a site
dedicated to
criticisms/complaints?
YES
Is this your area
of expertise?
YES

50. www.pwchealth.com

52. www.google.com/alerts
GOOGLE YOURSELF!

53. www.google.com/alerts

54. www.google.com/alerts

55. IRIS THIELE ISIP TAN MD, MSC
Director, UP Manila Interactive Learning Center
Chief, UP Medical Informatics Unit
Professor, UP College of Medicine
@endocrine_witch