Facebook is all about sharing. That’s why its apparent foray into healthcare is causing increased concerns about social media privacy.
According to Reuters, Facebook is reportedly at the early stages of building patient “support communities” and “preventative care” health and wellness apps that would gather health data from its one billion plus users.
The world’s largest social media network is said to be talking to experts in the healthcare sector to help carry out the plan. The company joins a growing list of tech players jumping on the healthcare bandwagon. Google, Samsung, and Apple have launched healthcare initiatives that tap into the boundless opportunities in the sector. Unlike its rivals, however, Facebook seems content at this nascent stage to build online communities like popular site PatientsLikeMe.
To allay privacy concerns, Facebook is reportedly launching its first health app under a different name. It could also allow users to post anonymously in their future online communities to encourage sharing. The site recently relaxed its policy of using real names instead of aliases that got some users banned.
But Facebook’s track record in safeguarding privacy has been spotty at best. Users have complained of complicated privacy settings, although the site said it has made things easier. It also experimented with users’ news feeds without prior notification.
Although Facebook has been upfront about using some information found in user profiles for targeted ads, users still complain of the increasingly intrusive nature and sheer number of ads on the site. Further concerns have recently been raised since the company will soon use new technology—Atlas—that can export user data beyond Facebook’s site into other Internet sites, particularly on mobile devices, for advertisers to utilize.
“This expands the surveillance economy into ever more important and intimate aspects of a person's life, particularly when it comes to cross-device targeting on mobile,” Neil Richards, a law professor at Washington University in St. Louis who studies digital privacy, told Info World.
Social Media Use Could Mean Insurance Benefit Loss
Facebook user Nathalie Blanchard found out just how sharing photos via the site could impact one’s health. She lost her benefits for her clinically-diagnosed depression after her insurance company saw her Facebook photos looking happy while attending a birthday party and spending a holiday at the beach, and concluded that she was actually not depressed.
As Insurance Quotes explains, “Underwriters are looking for things making you higher risk, noting possible habits you seem to enjoy, as well as your medical history. For example, smoking, drinking, or even leading a sedentary lifestyle makes you more vulnerable to serious health issues. Health insurers may deny benefits completely, deny claims, or even cancel coverage mid-policy.”
Insurance companies and their investigative arms are scouring social media sites for photos, videos, comments or “likes” that indicate a member’s lifestyle and health risk. Companies are also using social media to look for fraud, for instance, exposing misrepresentation of injuries in workers’ compensation claims.
That cautionary tale on privacy and many others like it could mean Facebook will take it slow with its healthcare ambitions.
“While some patients freely share information about their conditions, others prefer to keep that information private from colleagues, employers, marketers, or the world at large,” said Alison Diana of Information Week. “With complex, frequently changing terms of service and a poor track record of safeguarding users' privacy, Facebook will have a tough time convincing some users it will treat health-related information differently from cat videos or complaints about poor service at a restaurant.”
Perils in Clinical Settings
Insurers may be purposely using social media to get information, but frontline care providers may not realize how long the social media reach is—and some are learning it the hard way.
For instance, emergency room nurse Kati Duke was fired from her job at New York Presbyterian Hospital for posting a photo on Facebook-owned Instagram of a “messy but empty trauma room” where a man hit by a train was treated. She was fired not for violating HIPAA privacy rules, but for being “insensitive” in posting the photo which allegedly was re-posted from a doctor’s account.
HIPAA (Health Insurance Portability and Accountability Act of 1996), among other things, prohibits the unauthorized access, use or distribution of health information.
Dr. Alexandra Thran was fired from Westerly Hospital in Rhode Island for posting information on Facebook about a trauma patient, according to the Boston Globe. Thran did not name the patient, but she posted enough information for a third party to correctly identify the patient.
While patients are not technically covered by HIPAA (unlike “covered entities” such as providers and hospitals), they can also commit privacy blunders. For example, as related by FierceHealthcare, a patient videotaped another patient who was drunk in a trauma center, then later uploaded the video to YouTube, broadcasting the embarrassing event to countless viewers on the Internet.
Better Safe than Sorry
Patients and providers alike are being advised to err on the side of caution when it comes to using social media. That means avoiding oversharing of information and overstepping boundaries (e.g. “friending” patients).
The American Nurses Association (ANA) says: “Nurses must always be aware of potential consequences of disclosing patient-related information via social media and mindful of employer policies; relevant state and federal laws; and professional standards regarding patient privacy and confidentiality.”
The American Medical Association (AMA) recommends that physicians:
- “Use privacy settings to safeguard personal information and content to the fullest extent possible on social networking sites.
- Routinely monitor their own Internet presence to ensure that the personal and professional information on their own sites and content posted about them by others, is accurate and appropriate.
- Maintain appropriate boundaries of the patient-physician relationship when interacting with patients online and ensure patient privacy and confidentiality is maintained.
- Consider separating personal and professional content online.
- Recognize that actions online and content posted can negatively affect their reputations among patients and colleagues, and may even have consequences for their medical careers.”
According to Circulation, the journal of the American Heart Association: “Patients who desire to communicate with their healthcare provider via social media should be made aware of the privacy protections put in place by their physician or physician’s practice and should provide consent to participate given these provisions.”
Social Media’s Impact on Healthcare
Healthcare IT News cites surveys saying that “51% of patients say they’d feel more valued as a patient via digital health communications” and “41% of people said social media would affect their choice of healthcare provider.”
Moreover, an Institute of Medicine survey revealed that “With appropriate anonymity, 94% of American social media users with a medical condition would be willing to share their health data to help doctors improve care. The same proportion (94 percent) would be willing to do this to help other patients like them.”
Per a HIMSS white paper: “Social media is here to stay and will continue to grow. As such, organizations need to determine how to utilize them in a secure and private manner. Developing social media policies will be an important element in this process.”
If social media players like Facebook work together with the healthcare sector to come up with effective solutions to safeguard privacy, that could be a real turning point for social media to make a big impact in healthcare.