how social media is changing privacy in medicine
DESCRIPTION
April 16th, 2013 Evening rounds, St. Paul's Hospital Conference CentreTRANSCRIPT
“ How social media is changing privacy in medicine: some early ideas …
Dean Giustini | UBC Biomedical Branch Librarian | Adjunct Faculty, UBC’s iSchool
What is social about social media?
"...social media brings people together in order to chat often, talk and share, network and socialize; social media
encourages discussion, feedback, comments & information-sharing
instead of one-way (1.0) broadcasts … think of social media as two-way (2.0) highly-social conversations
Other aspects of what’s social about social media – which are your favourite social media tools?
Why bother with social media?
• Should everyone learn about the web's ecosystem? Why?
• Social media is altering the boundaries (pros & cons)
• Is social capital important in medicine? (Salvatore, 2006)
• Problem-based learning, evidence-based practice, teams
• Patients, physicians & information work together
Shared agency – doctors/patients
• Physician-patient relationship is deeply personal– Complicated by patient suffering (Latin: patior “to suffer")– Patient has limited ability to relieve problems on their own
• Physician viewed as one with power
• Physicians are aware of power imbalance
• Patient empowerment includes use of social media – Patients can take more responsibility for their care– Patients should regulate their own privacy controls
Privacy & Hippocrates
On privacy for the patient:
‘‘…what I may see or hear in the course of treatment in regard to patients, which no one must spread abroad, I will keep to
myself … holding such things shameful to be spoken about…’’
— Hippocrates (460 BC to 370 BC)
• Selective control of access to the “self”
• Dynamic, dialectic process of regulating relationships
• Optimization, multi-mechanism process
• Functions of privacy:– management of social interaction – plans & strategies for interacting with others– development and maintenance of self-identity
Altman’s (1975) theory of privacy
Privacy Management Theory (Petronio, 2002)• Relationships managed by balancing privacy and disclosure
• Privacy and disclosure function in “incompatible” ways
• Personal & collective boundaries
Privacy (Concealing) Disclosures (Revealing)
Privacy & medical professionalism
• Cheston 2012 systematic review, social media in medical education• breaches of professionalism (49% of articles)• user privacy (32%)• information quality (27%)
• Other concerns in the literature? • No time, lack of time, too many distractions• Distracted doctoring• Professional boundaries and confidentiality
• Personal boundary issues: relationships, private-public, ethical
• Social media redefines privacy in medical professionalism
Online medical professionalism: patient and public relationships. Ann Int Medicine April 2013
Patients need to ask good questions
• How can we participate in large social networks & protect privacy?– Privacy is a basic human impulse & central to patient care– Be aware of “context collapse” phenomenon on social sites
• Right to control our personal (health) information (& who sees it)
• Privacy in the past– Private information was locked away, and shredded– No longer appropriate for patients
See Pew’s document Privacy Management on Social Media
Privacy management & “context collapse”
Towards privacy literacy:
Privacy literacy refers to…the skills we need to engage fully in the digital world without compromising personal information …which
implies that individuals & organizations need a better grasp of privacy obligations & their importance in the digital landscape
— BC’s Privacy Commissioner
http://www.oipc.bc.ca/
• The web is a highly-social ecosystem & critical to life-long learning
• In medicine, 21st c. learning is highly social e.g., PBL, EBP
• Medicine is social but with exacting requirements for privacy
• Physicians must learn about privacy (and balancing its controls)
Some social media / privacy takeways
Social media & privacy literacy needed for the future of medical education…
Dean Giustini | UBC Biomedical Branch Librarian | Adjunct Faculty, UBC’s iSchool