Wednesday, August 11, 2010

Hospitals and Facebook Under Fire in HIPAA Related Dispute

William Wells arrived at the emergency room at St. Mary Medical Center in Long Beach on April 9 mortally wounded. The 60-year-old had been stabbed more than a dozen times by a fellow nursing home resident, his throat slashed so savagely he was almost decapitated.

Instead of focusing on treating him, an employee said, St. Mary nurses and other hospital staff did the unthinkable: They snapped photos of the dying man and posted them on Facebook.

Four staff members were fired and three disciplined, according to a St. Mary spokeswoman. At least two nurses were involved, but none was fired, a union spokesman said.

read full story here

This story has recently sparked outrage directed at facebook and medical institutions. To solve the problem, some feel facebook should not be accessed within a hospital setting. They further argue hospitals don't do enough to zip the lips of employees. After all, 14 year old Stephanie also had her picture plastered across facebook back in 2008. What about the EMT that took crime scene photos of 26 year old Caroline Wimmer-taken less than an hour after her death-and posted those to facebook?

I have to argue in defense of facebook and medical institutions-aka hospitals. First things first. Yes, I believe facebook should monitor closely the content that is posted on their site. However, they immediately took the photos down and even offered a tribute to the victims. They maintained an element of class and did the right thing when presented with the issue. Facebook is a social network-to eliminate its access in a hospital setting, I believe, would cut off great interaction between those in the medical field. There is a camaraderie between health care employees-they get each other. The day to day stress of saving lives and losing lives can only be shared adequately with those that experience the same thing. To share that element of pressure with those outside of the medical field would be, well, like holding a dead fish. No response. There is also a lot of consulting that goes on between the facebook walls of medical professions. I do not encourage the elimination of social networking within the hospital nor do I think it would make the problem go away.

Here is where the breech is occurring-within the employee. If it was within rules, all your hospital human resource department would have to do was state "Do not post photos of patients on facebook. Do not take photos of patients." See how ridiculous that sounds? Some things you should not have to tell a person. Some things lie within the integrity of an individual. If you have to point blank make the ruling "Don't take photos of patients", you have an integrity problem, not a problem within your regulations or within facebook.

You can not legislate compassion. Either your employees have it or they don't. You can't hold their hand and tell them how to act. The responsibility falls in hiring those that you believe will act in a graceful, compassionate, trustworthy manner, and then you fire them when they prove otherwise. You will make a pretty big "no tolerance" statement and those extra rules will be unnecessary.

Employees will talk. I know. I've been there when it happened over the body of a comatose patient, in a public elevator, even in the cafeteria. These are all places where confidentiality is breached. Here the patient is given a piece of paper upon admittance that states your hospital follows HIPAA guidelines, yet by taking locker room talk into the public arena, aren't the employees violating HIPAA? It all goes back to the integrity of the employee. Are they willing to hold to a higher standard of service or are they willing to breech the privacy of patients in the name of gossip? That is the question that needs to be addressed.

If hospitals have contributed, it is not within the context of allowing access to facebook. It lies within the focus and integrity of it's employees. Perhaps that is where this problem should be approached.

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