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2 days ago · Social Media Policies:Posts that technically don't contain PHI in Give & Get Advice

Ok at the risk of beating this to death, here’s something published yesterday, in the Mayo Proceedings that doctors currently give EHR usability an “F”. (See below)

I don’t think that is because EHR companies are bad or the IT people supporting these efforts aren’t good. In fact in my experience most people I’ve worked with ave always wanted to do their best work for their orgs patients.

Rather, I think the move towards data acquisition- either through EHRs, or data mining, or marketing analysis comes with downside risks, including by necessity seeing patients as data sources which are combined to develop “insights”. The real question is are these insights worth really worth it?

https://www.beckershospitalreview.com/ehrs/ama-study-physicians-give-ehr-usability-an-f-rating.html

4 days ago · Social Media Policies:Posts that technically don't contain PHI in Give & Get Advice

Although I don’t think there s ever a place to be rude or humiliate on Twitter, it may be OK to be negative if your written mission statement both personally and professionally allow it. For example if your purpose in vaccine advocacy and your position at work is congruent with it, then aggressively responding to disinformation could be appropriate. Note though I wouldn’t do this casually.

4 days ago · Social Media Policies:Posts that technically don't contain PHI in Give & Get Advice

It would be interesting to ask ones healthcare employer what outside companies currently have access to the EHR data sets. My suspicion is most CEOs/COOs couldn’t answer that question.

4 days ago · Social Media Policies:Posts that technically don't contain PHI in Give & Get Advice

Also, since we are on the subject of de-identification here’s one suggestion for everyone but especially physicians: don’t use social media to complain about coworkers- even de-identified – ever.

Venting on social media about your work and coworkers is nearly always a big no-no and “de-identifying” a coworker isn’t going to hold up.

(For me personally my rules are don’t tweet politics, don’t tweet
Religion, don’t tweet about patients, and don’t tweet negative).

4 days ago · Social Media Policies:Posts that technically don't contain PHI in Give & Get Advice

I think de-identification for a specific patient and HIPPA are important, but I think they are distractions to something much bigger.

For example, les say you are on a trip with your 5 year old little Johnny who had strep throat, and you check into a local urgent care center to get him checked. Undoubtedly when you check in an electronic chart will be opened, and you will given your friendly form about HIPPA and privacy to sign. All good and well. We want little Johnny safe and protected.

However, when you signed in, did you (and the other 35,000 patients seen in that single urgent care clinic that year) also give informed consent that little Johnnys visit (including height, weight, vital signs, zip code, billing info, unstructured comments with the nurse, medications, your name, … and 5000 other data points are all now able to be accessed by Google or Amazon Comprehend Medical, or Facebook, or whomever?

A problem with focusing only HIPPA and de-identification is it drifts towards reducing every patient encounter to dataset, which by definition is dehumanizing.

Anyway, no answers here. I am not even saying dehumanization is always bad, but I think there is something much bigger going on than simple privacy concerns.

4 days ago · Social Media Policies:Posts that technically don't contain PHI in Give & Get Advice

This ties into something quite timely -Googles Project Nightingale (https://www.theguardian.com/technology/2019/nov/12/google-medical-data-project-nightingale-secret-transfer-us-health-information) where they have been given access to millions of patient records “deidentified” -probably all quite legal, but certainly ethically challenging.

5 days ago

“ Utilizing social media, you can create content that is high-quality, engaging, and informative.”.

That’s a rosy outlook! But not easy to do well.

5 days ago

Some interesting facts, but I don’t think it gives a great “general theory” of emoji use, such as the why and the how. For example, is there an age-based utility? Is it really more personal? Should it be used by a person or a corporation? ….

There’s probably an rBook out there waiting to be written 😀🖊📒