Smart Phone and Social Media Use in Healthcare

Healthcare

Technology gives us more capabilities than we ever had before, and health care organizations need to ensure that their staff members are aware of the regulations surrounding the use of technology in the workplace, both for work-related activities and private activities. The prompt was of a nurse who took photos of a celebrity and texted them to her friend. This action constitutes a violation of HIPAA, wherein the Privacy Rule holds the health care providers must safeguard information from your medical records, any information that is recorded by the health care provider, billing information and any other health information (HHS.gov, 2015). Furthermore, there has clearly been an ethical violation committed with regards to the recording of the patient without their consent, and the distribution of that material. Patient information is always confidential in nature, by ethics even if not by law (Mulholland, 1994). This paper will examine the situation presented in the prompt through the lens of nursing privacy laws and ethics.

HIPAA Regulatory Requirements

The Health Insurance Portability and Accountability Act (HIPAA) includes in its provisions the Privacy Rule, which afford patients a certain amount of privacy in the digital age. The Rule "establishes national standards to protect individuals' medical records and other personal health information…" (HHS.gov, 2015). In part 164.105, the law references "protected health information" (HIPAA, 2007). Based on this, the nurse violated HIPAA by revealing the medical records of the victim, his demographic information including home address. Even the photograph of the victim, which would convey his current health status, may fall under HIPAA. The law exists to afford patients the right to privacy. While the law was written more specifically for the everyday conduct of a health care organization, as opposed to the use described in the case, but the nurse in question was a health care practitioner, on duty, and was therefore obligated to follow HIPAA regulations.

Smartphones

Smartphones have many uses in healthcare, though it is important to separate from the outset the scenario presented. The scenario presented did not represent a use of smartphones in health care. The nurse in question was not performing health care duties with her smartphone -- that was personal usage while on the job, which is an entirely different matter. Personal usage on the job is still subject to HIPAA, but it has nothing to do with actually using smartphones to conduct medical business.

Smartphone applications have proliferated in health care, and that is one advantage. Applications can, for example, receive data from a monitor that the patient wears via Bluetooth, and then based on this information perform tasks. This can include calling emergency should a patient's heart rate drop suddenly, or this technology could be used to regulate medical equipment, IV drips or drug intake. More mundane uses include communications -- the patient to use an app to get a routine prescription and subsequently submit it to a pharmacy for delivery, conceivably getting information without leaving home (Li, 2014). A third advantage, this time of social media, is that it provides marketing and information opportunities, as well as opportunities for more outreach to the community (Moorhead et al., 2013).

While smartphones enable data to be moved more quickly, this movement must also be combined with safeguards to protect sensitive data, as easier flow of sensitive data is a distinct disadvantage. This may involve things like encryption, for example, but such safeguards are necessary to maintain a health care provider's HIPAA requirements. The same holds true for other organizations, such as insurers, who are also covered under HIPAA and handle sensitive medical information. For its part, social media does not really have applications in health care, other than perhaps in research. Social media can, however, create HIPAA problems for health care practitioners, if they use social media or even direct email/text applications, to reveal protected information to people outside of health care need, as was the situation in the case. A third disadvantage for social media or smartphones in health care is that there can be significant misinformation among the public, and it can spread much faster, as evidenced by the Ebola scare and the anti-vax loonies.

Ethics

The ethics of technology and health care are not much different from any other ethics. The nurse sharing these photographs with her friend via her smartphone is no better, ethically, than if she had gossiped about this at another point outside of work. Ethically, health care professionals are bound to protect the privacy of their patients, and this nurse violated that privacy with her smartphone usage. The fundamental ethical principles of protecting privacy can be violated without smartphones, but perhaps some people need to be reminded that it is easier to violate privacy with smartphones and such behavior is still not acceptable, nor ethical, and it is certainly not legal.

Conclusions

For the sake of argument, the nurse does #3. This scenario does not increase the legal and ethical violation, which has already been established. But it does increase the damage to the patient, and it increases the chance that the nurse will be caught -- and subsequently punished. The employer is more likely to fire the nurse if she has this poor judgment, to post this protected information, after having slept on it. The nurse could probably talk her way out of firing based on the initial violation, because it was in the moment and in a private conversation with her friend. But public broadcast would make the matter that much worse, and increase the odds of a lawsuit or HIPAA prosecution that much more -- the health care organization would have no choice but to take decisive action against the nurse.