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A need for employee social media policies in health care

Several cases involving health-care employees who posted workplace information on social media have led to a growing number of institutions and regulatory colleges developing proactive policies to prevent this from happening, says Toronto health lawyer Kate Dewhirst.

“It sounds like a really bad idea for an employee to post information about his/her health-care workplace, but people do it and it’s important for organizations to talk about this during training,” she tells AdvocateDaily.com.

The College of Nurses of Ontario and the College of Physicians and Surgeons of Ontario both have adopted policies on the use of social media.

Dewhirst, principal at Kate Dewhirst Health Law, points to an Ontario arbitration case concerning an employee of the former Credit Valley Hospital (now Trillium Health Partners) in 2012. In this matter, a hospital employee was fired after he posted pictures on Facebook of a scene where a young patient had jumped to his death in a hospital parking lot.While he did not post pictures of the body, he did post comments that were insensitive and revealed the nature and location of the death.

The arbitrator in this case, who upheld the employee’s termination, noted that the employee should have known that the individual who died was a patient and that the posting of the photos wasn’t a momentary lapse in judgment because of the time that had elapsed between the posting of the two photos and the related commentary. The arbitrator also emphasized how the employee was not remorseful and that a message of deterrence was important.

Dewhirst notes that while it “always takes a little while for regulations to catch up with technology,” an influx of organizations are now developing policies about employee use of social media in health settings.

The lawyer says this case and others highlight the need for health-sector organizations to develop policies so that employees are clear about what they can and cannot say online about their work.

“When I’m training health-care providers and anybody who works for a health-care organization, my main message is that people who work in health care just do not have any discretion to post information on social media about their work – so no commentary about people who receive care at their organization; no commentary about the kinds of activities they do and perform,” she says. “It’s very difficult to anonymize their stories and experiences so there are serious risks of privacy breaches.”

She also stresses that employees “shouldn’t be using social media to complain about their workplace or co-workers.

“And this applies even more so in health care because of the overlay of the patient privacy issue,” she says.

Dewhirst also points to another employee grievance, Chatham-Kent v. CAW 2007, that involved the termination of an employee who had blogged about residents of the home for the aged where she worked and her co-workers. The employee, who worked at the facility for eight years, only used first names in her blog, but pictures of staff and residents were uploaded. The woman apologized for her actions, but her termination was upheld by an arbitrator, who found that the postings amounted to insolence and a grave breach of confidentiality.

For the most part, Dewhirst says the concern here isn’t one of criminality; it is rather, the risk of privacy breaches and risk of boundary violations where the regulatory colleges will caution their members from becoming too familiar with their patients.

“If you are friends with patients on social media, you have entree to their lives that you wouldn’t normally have in the clinical relationship,” she says. “It really blurs the lines between professional and personal. Regulatory colleges are concerned about health care providers maintaining professional boundaries.”

In addition, health-care providers have to be careful about using social media to communicate with patients because “it might create problems when it comes to managing health emergencies,” says Dewhirst.

“It may be that patients think they can get urgent consultation by using Twitter or Facebook,” she says. “Health-care providers have to be careful to counsel patients that if there is an emergency to call 9-1-1 or go to an emergency department and to clarify that the best way of reaching them is to call the office .”

 

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