Protected health information on social networking sites: ethical and legal considerations.
Protected health information on social networking sites: ethical and legal considerations.
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DOI：
10.2196/jmir.1590
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发表时间：
2011-01-19
影响因子：
7.4
通讯作者：
Dawson K
中科院分区：
文献类型：
--
作者：
Thompson LA;Black E;Duff WP;Paradise Black N;Saliba H;Dawson K
社交网站的使用在新兴的医学专业人士中越来越普遍，医学院甚至报告了纪律处分的学生被开除。使用社交网站的医疗专业人员有独特的责任，因为他们的帖子可能侵犯病人的隐私。然而，学生和居民是否描绘受保护的健康信息，以及在什么情况或背景下，这是未知的。我们研究的目的是记录和描述医学生和居民Facebook个人资料中潜在的患者隐私侵犯的在线描述。2007年和2009年，一个多学科团队在佛罗里达大学对所有医学生和居民进行了两次横断面分析，以了解谁拥有Facebook个人资料。对于每个已识别的个人资料，我们手动扫描整个个人资料，以获取受保护健康信息的任何文本或照片表示，例如人员的描述，姓名，日期或程序描述。几乎一半的合格学生和居民拥有Facebook个人资料（49.8%，或2053人中的1023人）。有12起潜在的病人违规事件，其中学生和居民张贴了他们向个人提供护理的照片。没有居民或学生张贴任何可识别的病人信息或类似的文字形式。每起事件都发生在发展中国家，显然是医疗使命旅行。这些描述随着时间的推移而增加（2007年队列中1例; 2009年11例; P = .03）。医学生比居民更有可能在他们的个人资料中有这些潜在的违规行为（11比1，P = 0.04），并且没有性别差异。照片包括受训人员与可识别的患者（所有儿童）互动，或进行医疗检查或为儿童接种疫苗等程序。虽然这项研究中的学生和居民正在张贴可能侵犯患者隐私的照片，但他们似乎只是在医疗使命旅行的设置中犯了这个错误。受训者需要学会在所有医疗环境中使用法律的和伦理的论点来等同患者隐私的标准，以维护最高的专业原则。我们提出了三个切实可行的指导方针。首先，应该有一个法律的资源，为医生旅行的医疗使命之旅，如当地法律的在线列表，或电话法律的联系。第二，组织医疗使命旅行的机构应在任何旅行出发前计划一次道德研讨会，因为法律的和道德影响可能不是直观的。最后，旅行医生至少应该对任何情况适用最严格的法律的先例。
Social networking site use is increasingly common among emerging medical professionals, with medical schools even reporting disciplinary student expulsion. Medical professionals who use social networking sites have unique responsibilities since their postings could violate patient privacy. However, it is unknown whether students and residents portray protected health information and under what circumstances or contexts. The objective of our study was to document and describe online portrayals of potential patient privacy violations in the Facebook profiles of medical students and residents. A multidisciplinary team performed two cross-sectional analyses at the University of Florida in 2007 and 2009 of all medical students and residents to see who had Facebook profiles. For each identified profile, we manually scanned the entire profile for any textual or photographic representations of protected health information, such as portrayals of people, names, dates, or descriptions of procedures. Almost half of all eligible students and residents had Facebook profiles (49.8%, or n=1023 out of 2053). There were 12 instances of potential patient violations, in which students and residents posted photographs of care they provided to individuals. No resident or student posted any identifiable patient information or likeness in text form. Each instance occurred in developing countries on apparent medical mission trips. These portrayals increased over time (1 in the 2007 cohort; 11 in 2009; P = .03). Medical students were more likely to have these potential violations on their profiles than residents (11 vs 1, P = .04), and there was no difference by gender. Photographs included trainees interacting with identifiable patients, all children, or performing medical examinations or procedures such as vaccinations of children. While students and residents in this study are posting photographs that are potentially violations of patient privacy, they only seem to make this lapse in the setting of medical mission trips. Trainees need to learn to equate standards of patient privacy in all medical contexts using both legal and ethical arguments to maintain the highest professional principles. We propose three practical guidelines. First, there should be a legal resource for physicians traveling on medical mission trips such as an online list of local laws, or a telephone legal contact. Second, institutions that organize medical mission trips should plan an ethics seminar prior the departure on any trip since the legal and ethical implications may not be intuitive. Finally, at minimum, traveling physicians should apply the strictest legal precedent to any situation.
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