Before you accept that Facebook "friend"

Did you know? Nearly one in four nurses say they've received a Facebook friend request from a patient. The real number is probably closer to 2/3 of your clinical team having received a request to befriend a patient on social media.

Before your employees hit "accept," here are four important integrity and compliance issues to consider:

1. TMI

If your employee's social media privacy settings aren't set up correctly, patients now have access to a great deal of personal information; information that could affect their feelings of trust and safety in the care your employee is providing.

Moreover, staff will see things they may not want or need to know about patients' personal lives. Perhaps the patient reported financial distress, but your employee sees an Instagram photo of a new car. Perhaps the patient reported suffering from a severe mobility issue, but the employee sees them tagged in a recent Triathlon photo.

Is your employee allowed or obligated to report this information to the care team? Could or should this information change the way care is provided?

Some online searching is legal. HR staff can do specific research, when evaluating a new hire, and psychiatry staff may be allowed limited searches, as well. But the slope is very slippery.

2. Violates patient privacy

Imagine: Before socially connecting with your employee, a patient "checked in" on Facebook for their appointment at your clinic. They include a comment about the specific surgery they're feeling anxious about. 

Your employee and this patient become Facebook friends, and your employee "Likes" one of the patient's recent profile photos. One of your employee's existing Facebook friends sees a notification in their newsfeed, indicating that your employee and this patient are now "friends." The friend clicks on the patient's name and is now scrolling through their personal photos and updates.

Oops. Your employee has just disclosed this patient's status on their behalf and without their consent.

3. Encourages inappropriate conversation

The complications of a digital relationship with your patient don't stop with an accepted friend request. A Facebook friendship opens the door for public, traceable conversations that can turn inappropriate quickly.

What if your patient comments on your page about issues they're having with billing or receiving a referral? Are you obligated to respond?

What if they start asking you specific questions related to their care? What if you answer and give them incorrect care instructions?

What if they start posting slanderous remarks about your colleagues? Should you report them to your manager or the union?

4. Mark Zuckerberg owns it all

It's tempting for employees to think that private Facebook messages they send to patients are, in fact, private. However, everything shared on a social media platform is owned by the platform, not you.

When residents exchange patient information via Google docs, they have - albeit unintentionally - breached HIPAA, because that content is now owned by Google. The same principle goes on Facebook and Twitter and LinkedIn.

We know real, important relationships develop between patients and staff during the course of care, but it can be incredibly risky to carry those relationships into the digital space. When you share something on social media, that content is no longer yours; it's not private and it's not protected. 

Be sure your staff understands the serious ethical and legal issues associated with patient digital engagement and establishes clear online boundaries.

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