Health Is Social

Infusing Social Media into Healthcare

Dark matter is a curious thing. Apparently its a huge part of the universe, but we don’t know much about it. If you’re bored, read this.

Ethics is a curious thing too. Ethical problems abound us. They’re a huge part of the human universe. But – like dark matter – we don’t always see them.

The presence and evolution of social media explosively bring forth into our world new ways of doing things.

Media, like all technologies, reveal and conceal.

The telescope reveals the star and conceals the cell.

The microscope reveals the cell and conceals the star.

The tweet reveals the idea and conceals the context.

This revealing-concealing process of social media implies that the process has within it a seducing deception.

There are subtle ethical issues raised by social media pervading of all facets of life.

For example: Is it ethical for a hospital to monitor mentions of their brand?

On the surface, a common reaction would be “Why yes – if a patient publicly posts a blog or a tweet, all’s fair because it’s in the public sphere”.

But that’s a legal en-framing of the question – not an ethical one. And many people confuse Ethics with Law. The two disciplines are completely different – they overlap, but they’re different.

I won’t answer the question about the ethics of hospital monitoring brand mentions. (For other reading on this, check out @amcunningham post here.)

What I would strongly argue, however, is that hospitals and their agencies have a responsibility to plumb the question.

You see, in ethical investigations, it’s the process of philosophical investigation that leads to new land.

I’m afraid that too many people misunderstand Social Media, in spite of actively using it and working with it.

What I mean more specifically: They aren’t Questioning Concerning Social Media with sufficient depth. (I know, Heidegger gets a little heavy – don’t think too much here 😉

I only cited the hospital brand monitoring. It’s a simple question – but the more you explore it, the more you go “Oh c**p, I didn’t think about that…Yikes, I never even considered this…And, OMG, if this situation arose, this might become a major legal issue…You know, I never thought we could hurt someone in this way. Glad we thrashed these out now.”

There are  many other ethical matters in social media to explore. Twitter, Facebook and the fattening spectrum of other social media strain human brains, so that the surface gets more attention than the depths.

There’s a lot of Dark-Matter Ethics out there in the expanding universe of social media. Now’s a good time to get to know what surrounds you.

Let me leave you with this hypothetical:

Your hospital has just received a court injunction to stop monitoring a named patient’s online presence and social graph.

What do you do now?

(You’ve thought about this one, so you probably already have the answer. I’m quite sure of it.)

Phil Baumann

@HealthIsSocial

484-362-0451

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  • You pose an interesting question. But I can’t help feel that this debate is somewhat over-reaching the reality of where health organisations are in terms of social media.
    Most of the original debate focused on hospitals and others monitoring mentions of their name – to pick up on complaints and praise. I think this should be standard practice, as it is in many other sectors.
    Monitoring patient’s profiles is quite different and I agree that there is much more to be discussed around this. But let’s not confuse the two activities and risk taking social media out of the mix altogether.

    • Phil Baumann

      Actually, the two aren’t being confused here and it’s not over-reaching the debate.

      That’s the whole point: I’m challenging the very dismissal implicit in your (good) point.

      The question I posed at the end is about – as I said – the process., not an actual answer.

      If you process the question a bit more, you might be surprised what you discover 😉

  • Phil —

    I agree that the process of arriving at an approach that is consistent with an institution’s stage in social media evolution and other local factors is critical (can’t just copy a social media policy and change the names; can’t expect to implement and live by a policy that is not developed organically by the folks who have to live with it), and that there is some inevitable overlap of the ethical and the legal issues. You are right to highlight the need to address the “purely” ethical issues up front as a matter of institutional policy.

    Most health care providers searching on patients, or following them online are likely doing some reasonable investigative work, trying to reach a diagnosis, trying to separate lies from truths presented by an unreliable reporter (or even trying to divine information about an unconscious patient — I posted about this a while back, and it seems to be a useful adjunct to other tools, but not a replacement for the EHR, as some have argued: Facebook Saves Woman’s Life: Newt Gingrich and Reality-Based Healthcare Systems Planning | HealthBlawg – http://bit.ly/t43fff). I’m trying to imagine the provider cyberstalking the patient in the question you posed at the end — and I’d be surprised to learn that a court issued an injunction if there were no unwelcome communication from provider to patient involved. That would put it in a whole other category – not just looking at stuff that’s posted out in the open.

    BTW, @amcunningham directed me to this post this morning, and her post about the NHS patient whose online postings were monitored by his care team a year ago got me thinking about this issue as an issue in the first place.

    My thought at the time was that this “snooping” on stuff posted in the open is a more benign version of the diagnostic detective work portrayed on some TV shows (which involved breaking and entering, raising legal as well as ethical issues, but I digress). If I remember correctly, the NHS patient in the original case study was surprised but appreciative when offered tips on care management or diet prompted by his online postings.

    Bottom line: health care providers need to have more thoughtful policies and procedures to deal with all this, but cybercitizens need to take some personal responsibility, too.