Wednesday, May 7, 2014

On Healthcare & Technology

     This post may be on the intersection of healthcare and technology, but in a way it's just a portion of the way technology is used - social media. Otherwise, I could make this part one of many, and I'm not sure I want to do that just yet. This came up recently at work; a family member was trying to film some nurses doing their jobs while the family was in disagreement with or simply unsatisfied with the health care team about their loved one's care.

     Today I want to share some of my thoughts on why it can become an issue that technology is everywhere, and that so many people are trigger-happy with that "Share" button for social media.  These days, most healthcare facilities have several policies on the use of technology and social media, if not a person whose job that is, or even entire departments devoted to it.  Sometimes they cover the public relations for the facility, and most of the policies relate to how staff members are expected to appropriately use technology/social media, but some are focused on how members of the public can use technology and social media while in that facility.  For example, I have heard of a hospital where the staff is instructed to not allow family members to film the birth of their child, because it's against the policy.  I think that's an extreme end of the spectrum, but let me explain some of what our thinking is (members of the health care team, that is).

     First, and the biggest concern for hospitals, is that the use of technology and social media in patient care areas is a major threat to patient privacy, which is protected by federal laws, and enforced with hefty fines against the facility. It doesn't matter if the hospital has no idea that the relatives of the patient next door to you take a picture that has your name and room number in the background, or you for that matter, and post it online, it's considered the hospital's breach of HIPAA laws and the facility pays the price.  The fact that technology is everywhere means that we have hardly any control over this happening, so if we do see it, we don't allow it.  

     Now what if you want to take a video of me while I'm doing my job, whatever the motivation?  I personally wouldn't let you film me doing my job, for several reasons, whether or not my facility has a policy against doing so.  Primarily my concern in that situation is quality of care.  I don't need to deal with the distraction when I'm in the middle of a code blue, or any situation that may arise in ICU (or elsewhere).  This use of technology is very distracting, and cannot simply be ignored, because of a few problems.  One, if you are not 100% satisfied with my care, or your doctor's care, etc,  you can put me and my facility in the court of public opinion by posting a video online, rather than through normal channels of making a formal complaint, that goes to people that hear both sides, and know all the facts and variables.  This is especially true because anyone can edit a video to show only what they want to show!  I could easily lose my job and risk losing my license because of someone's vendetta -- like I said, public relations, which sometimes necessitates that the facility take action so they look like they're doing something about a situation, even if the person getting fired is really a scapegoat.  The second problem is a more personal one: I have no control over my personal privacy if you take a video of me and post it online.  I personally am fairly cautious about what I post online, and am extremely guarded about what I own up to by attaching my own name (searchable by future employers, to say the least). If you take a video of me, and list my name (even if it's a generally positive video!) I still have no control over it.

     Thankfully, this issue doesn't come up terribly often for me, but in some areas of medicine/nursing it comes up frequently. One of those areas is, of course, labor and delivery, where people want to film their births. I think this should generally be an exception to the facility's rules about video/photos, because it's a very special moment in a family, and not merely a medical issue.  I can, however, completely understand why a facility would want to cover themselves by outlawing even that.  If something goes wrong during the birth, you have proof that you can manipulate through editing to say whatever you want when you go to sue the doctor and/or facility.  The reality is, you as the patient chose to give birth at that hospital, and by doing so must abide by their policies.  You have options (usually).

     Like I said, I think there should be exceptions to these policies. I am fine with photos and video as long as they are in the patient's room (and it's a private room) so that no other patient's privacy is infringed upon, and as long as they are patient-focused.  I would allow and even encourage recording video messages or taking photos/videos of a person who was dying, for example.  The main difficulty is that hospitals have an easier time enforcing an across-the-board, this-is-never-allowed sort of policy than any policy that involves exceptions for certain circumstances. Just look at visiting hours policies to see proof of that!

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