Saturday, June 27, 2009

Lyrics: Beautiful Dreamer = Meaningful User

A couple weeks ago I had the idea that the song "Beautiful Dreamer" had the same number of syllables as "Meaningful User," so started to rewrite the lyrics appropriately (I love doing stuff like that). But I guess my creative spark fizzled and only got the first verse done.

Here are the original lyrics:

Beautiful dreamer, wake unto me,

Starlight and dewdrops are waiting for thee;

Sounds of the rude world, heard in the day,

Lull'd by the moonlight have all pass'd away!

Beautiful dreamer, queen of my song,

List while I woo thee with soft melody;

Gone are the cares of life's busy throng,

Beautiful dreamer, awake unto me!

Beautiful dreamer, awake unto me!

Beautiful dreamer, out on the sea

Mermaids are chanting the wild lorelie;

Over the streamlet vapors are borne,

Waiting to fade at the bright coming morn.

Beautiful dreamer, beam on my heart,

E'en as the morn on the streamlet and sea;

Then will all clouds of sorrow depart,

Beautiful dreamer, awake unto me!

Beautiful dreamer, awake unto me!

Here's what I came up with so far...

Meaningful user, wake unto me,

Certifications are waiting for thee;

Sounds of our health care, falling away,

Lull'd by C-C-H-I-T saving the day!

Meaningful user, no one defines,

Stimulus money for healthcare IT;

Will it prevent us from losing our minds?

Meaningful user, awake unto me!

Meaningful user, awake unto me!

Please have a go at finishing it up in the comments. Thanks.

Tuesday, June 16, 2009

Meaningful Use: Official Draft Definition Released by HITSP

The anticipated release of the draft definition of "meaningful use" (mentioned in ARRA but not defined) was released by the HITPC (Health IT Policy Committee) today.  There is a public comment period ending June 26 (max 1000 characters).  All public comments should be sent to  The anouncement is on the HHS website.

The preamble describes the framework, while the matrix lays out the five policy priority areas and the target measures for each 2-year block (2011, 2013, 2015).  The 5 areas are:
  • Improve quality, safety, efficiency, & reduce disparities

  • Engage patients & families
  • Improve care coordination

  • Improve population & public health

  • Ensure privacy & security protections

Each area has associated Care Goals (eg, use evidence-based order sets and CPOE; provide transparency of data-sharing to patient), along with Objectives and Measures for each of the three 2-year blocks.  Check out the Matrix for details (alternatively, just follow the white rabbit).

So, for example, under Improve Care Coordination, we have the following:

Care Goal
Exchange meaningful clinical information among professional health care team

2011 Objectives 
(Goal is to electronically capture in coded format and to report health information and to use that information to track key clinical conditions)
  • Exchange key clinical information among providers of care (e.g., problems, medications, allergies, test results) [OP, IP]
  • Perform medication reconciliation at relevant encounters [OP, IP]

2011 Measures
  • Report 30-day readmission rate [IP]
  • % of encounters where med reconciliation was performed [OP, IP]
  • Implemented ability to exchange health information with external clinical entity (specifically labs, care summary and medication lists) [OP, IP]
  • % of transitions in care for which summary care record is shared (e.g., electronic, paper, eFax) [OP, IP] 

2013 Objectives 
(Goal is to guide and support care processes and care coordination) 
  • Retrieve and act on electronic prescription fill data [OP, IP]
  • Produce and share an electronic summary care record for every transition in care (place of service, consults, discharge) [OP, IP]
  • Perform medication reconciliation at each transition of care from one health care setting to another [OP, IP]

2013 Measures
  • Additional public reports using NQF-endorsed HIT-enabled quality measures [OP, IP]
  • % of transitions where med reconciliation was performed [OP, IP]
  • % of encounters where fill data accessed [OP]
  • % of encounters where clinical information is shared with external clinical entities [OP, IP]

2015 Objectives 
(Goal is to achieve and improve performance and support care processes and on key health system outcomes) 
  • Access comprehensive patient data from all available sources

2015 Measures
  • Aggregated clinical summaries from multiple sources available to authorized users [OP, IP]
  • NQF-endorsed Care Coordination Measures (TBD)

There was a lot of discussion about moving some of the more distant objectives up sooner.  This part of the discussion (before the lunch break) was tabled, and a plan to release a revised draft was described.  

There was also quite a bit of Twitter discussion as well (see search.twitter).

If you'd like to read the transcript of the conference call, check out Brian Ahier's blog.

Sunday, June 14, 2009

#hcsm: Jun 14: Legal Issues Around Use of Social Media in Health Care

Whew! This one was a doozy. Instead of the usual 4-5 topics, there were 900 (well, it felt like that).  This is my recap.  Note: These are just my own personal notes from the Sunday night #hcsm chats on Twitter. It's what I found interesting or memorable or wanted to be able to easily refer back to.

We were treated to two "guest" tweeters, both health attorneys.  From @healthsocmed :

-@danielg280 is Daniel Goldman

Dan is a graduate of UCLA and UVA law school, chair of Business Law group at Mayo Clinic and member of Mayo Clinic's brand management team. Practice in the areas of business law, copyright, trademark, telemedicine, privacy and internet.  Biggest claim to fame is legal counsel for Mayo Clinic's Social Media efforts headed by @Leeaase

-@healthblawg is David Harlow

David’s legal and consulting practice includes advising health care providers of all shapes and sizes on a variety of business and regulatory issues, including HIPAA compliance, patient communications and more. Please contact him if you require such services.  



The Disclaimers

*No legal advice will be offered during this chat event*

"No legal advice" means the attorneys will not address specific use cases (e.g. "at my hospital, we have this social media problem, what is your advice")

The attorneys will engage on general issues, concerns and legal topics related to the use of social media in healthcare

The tweets: 

  1. David Harlow
    healthblawg Biggest areas of concern ppl have re healthcare SoMe is HIPAA and privacy law. Right area to be concerned abt. #hcsm
  2. David Harlow
    healthblawg Fed and state healthcare privacy laws interact and overlap; EU & other int'l law to think abt given global reach of www #hcsm
  3. David Harlow
    healthblawg Under HIPAA, 'covered entity' can't release PHI to 3rd party w/o pt consent. #hcsm
  4. David Harlow
    healthblawg Providers get consent up front by having pts sign notice of privacy practices (NPP); need to articulate planned use for PHI in NPP #hcsm
  5. David Harlow
    healthblawg State law can be stricter than HIPAA (recent NV and MA general privacy laws, focused on protection against ID theft) #hcsm
  6. David Harlow
    healthblawg Another area of concern: mandated reporting. St law often make providers mandated reporters of things like gunsht wnds, domestc violnc #hcsm
  7. David Harlow
    healthblawg I mention mandated reporting laws as example of how receiving info via SoMe may trigger obligations beyond obligs to pt #hcsm
  8. David Harlow
    healthblawg Mass. law, for example, applies to doc who is attending or treating pt w GSW What does attending or treating mean? #hcsm
  9. David Harlow
    healthblawg When docs offer medical advice via tweets or other SoMe I'd say they are 'treating' #hcsm
  10. David Harlow
    healthblawg #hcsm But let's step back a mopment... IMHO, this is all a bit academic right now. The @susannahfox Pew/CHCF rpt, 'The Social LIfe of Health Information' released last week says only 6% of people want health info via SoMe Now, @edbennett says that will change, and I agree - change will come, and so we have the opportunity to plan, lay groundwork for these interactions, develop rules of the road for the future: like rewriting NPPs with SoMe in mind, for example.... Read More:
-- this quote was brought to you by quoteurl

  1. danielg280
    danielg280 Gd evning. Jst a remndr that I’m a civilian tonight. My opnions r my own, not my employer's. Also, this is gen'l info, not legal advc #hcsm
  2. danielg280
    danielg280 Laws to be aware of: State licensure laws for docs and nurses: Center for telehealth and ehealth law: #hcsm
  3. danielg280
    danielg280 Copyright law and fair use: Stanford Libraries C page: Disney C parody #hcsm
  4. danielg280
    danielg280 Defamation: Electronic Frontier Foundation Blogger’s legal guide: #hcsm
  5. danielg280
    danielg280 Trademark law: INTA trademark basics: #hcsm
  6. danielg280
    danielg280 Most medical practice acts are broad and cover any attempts to heal or diagnose, whatever the means #hcsm
  7. danielg280
    danielg280 T 3.1, Generally this is fine, so long as its voluntary and the patient signs a hipaa compiant auth #hcsm
  8. danielg280
    danielg280 Key is to make sure patient really understands what they're getting into. Don't want to have them surprised they're on network tv #hcsm
  9. danielg280
    danielg280 Generally claims of "best" are puffing, and ok to say without support. #hcsm
  10. danielg280
    danielg280 May not need an auth if only allowing a forum for them to do it. May need an auth of directly soliciting #hcsm
-- this quote was brought to you by quoteurl

NOTE: These tweets are not necessarily in order. QuoteURL is not consistent about that.

  1. Stephanie Thum
    stephaniethum @healthblawg Does that mean language in NPP practices documents need to change to include SM references as a "planned" use? #hcsm
  2. robert hsiung
    dr_bob @healthblawg yes have to be careful about creating an online doctor-patient relationship #hcsm
  3. drval
    drval @healthblawg But what constitutes medical advice? A direct suggestion to a specific person to change mgmt or DO something? #hcsm
  4. Christian Sinclair
    ctsinclair @healthblawg What is the difference between medical advice and education about medical topics? Are there cases debating this? #hcsm
  5. Roy fromShrinkRap
    ShrinkRapRoy "advice"'s all in what you say & how you say it. Need to speak in generalities and veer away from specific case.
  6. Craig Stoltz
    craigstoltz "Advice" easy to spot/disclaim in "long" form online media. In a Tweet, hard to draw line between [actionable] advice & benign info #hcsm
  7. David Harlow
    healthblawg @drval Sounds about right; so need to est MD-pt rel 1st IRL #hcsm
  8. robert hsiung
    dr_bob @ctsinclair education is general, treatment is specific to the patient #hcsm
  9. Christian Sinclair
    ctsinclair @dr_bob Yes but any education may be considered specific from the pt point of view and therefore become advice
  10. David Harlow
    healthblawg @stephaniethum Yes I think NPP's need to be updated to reflect SOMe use #hcsm
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Fact or Myth

T1.1 Fact or Myth: Patients can disclose PHI, evaluate docs, payers, providers anywhere/anytime using social media. Providers not in control.

  1. candacee116
    candacee116 Everyone owns their own story. If they wish to share on a soc/med site-they are giving permission
  2. Christian Sinclair
    ctsinclair T1.1 I vote Fact. RE: Patients can disclose PHI, evaluate docs, payers, providers anywhere/anytime using social media. #hcsm
  3. David Harlow
    healthblawg T1.1 Pt can disclose own info; if provider sponsored forum important to have notice re lack of privacy #hcsm
  4. Patrick Mann
    patrickmann How can a doc truly a patient is who they say they are over SM? #hcsm
  5. chrisboyer
    chrisboyer Re: T1 - i would like to agree with @ctsinclair - I would like for this to be ffact. #hcsm
  6. danielg280
    danielg280 1.1 Fact Patient controls own PHI and can disclose.Can also say what they want re docs, subj to limits of libel Must be opinion or tru #hcsm
  7. robert hsiung
    dr_bob @patrickmann on SM nobody knows if you're a dog #hcsm
  8. Brian Ahier
    ahier anyone have real-life examples of pt testimonials on hospital blogs? #hcsm
  9. Steven Barley
  10. chrisboyer
    chrisboyer @MarksPhone I believe a patient can comment wherever they want, whenever they want on SM. That's they're right. #hcsm
-- this quote was brought to you by quoteurl

T1.2 Fact or Myth: Providers should never follow, friend or reply to patients via social media, HIPAA absolutely forbids this.

  1. Roy fromShrinkRap
    ShrinkRapRoy RT @patrickmann How can a doc truly a patient is who they say they are over SM? [good point]
  2. danielg280
    danielg280 Spoofing is a concern on SM, which is why it's generally not a good idea for true treatment relationship without a way to validate id #hcsm
  3. Nick Dawson
    nickdawsonhc do patients have an expectation that they will be treated via SM? #hcsm
  4. candacee116
    candacee116 Ithink you should not create a relationship separate from provider/patient on soc media such as FB or MS but reply on email to patient #hcsm
  5. David Harlow
    healthblawg T1.2 Best practice: advance consent; online or paper, should be part of std HIPAA NPP (notice of privacy practices) #hcsm
  6. danielg280
    danielg280 Close to fact: Prvdr mst be mindful of pvcy obligations and HIPAA in all interactions. Evn Disclosing that someone is a pt is a prob #hcsm
  7. Nick Dawson
    nickdawsonhc I think most PTs understand that SM is like a cocktail party. Ask general questions, not seeking treatment. seems a moot point to me #hcsm
  8. candacee116
    candacee116 If they are in rural area, this may be only means of health info communication-they may need Dr to friend them to establish connection #hcsm
  9. MacArthur Obgyn
    macobgyn How is a patient asking me questions after hours via SM any different than the pt calling me through the office paging system?
  10. Mark Scrimshire
    ekivemark #hcsm Seems like we need an "I opt out of HIPAA" just like we have a "Do Not Call" Registry
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T1.3 Fact or Myth: Employees have no right to use social media "on company time" for personal matters. Blocking access is ok.
T1.4 Fact or Myth: Employers cannot regulate employee speech-employees can use personal PCs/phones, networks & *personal* social media accts

  1. danielg280
    danielg280 t1.3 true No employee "rights" to do this. Employers can limit or allow as they see fit. dsnt mean it's a good idea #hcsm
  2. candacee116
    candacee116 Employees deserve breaks can't they go on then? #hcsm
  3. MacArthur Obgyn
    macobgyn RT @GraftFinder: I think we should start by referring to SM as "Communication" not "media" it portrays the wrong picture. #hcsm
  4. David Harlow
    healthblawg T1.3 Agree w Dan. However: employee morale issue, and need to enlist employees as SoMe ambassadors now or later so why piss them off? #hcsm
  5. Mark Scrimshire
    ekivemark #hcsm T1.3 Employee personal use - If employers want to go there then they should accept not being able to contact off duty employees
  6. Aurora Health Care
    Aurora_Health @healthblawg employees as ambassadors has great value if directed w/in appr. guidelines #hcsm
  7. Roy fromShrinkRap
    ShrinkRapRoy T1.3 Agree, no RIGHT to use SM for personal use. But are what we doing here "personal" or "work-related"? Both? #hcsm
  8. Craig Stoltz
    craigstoltz Re: Employee use of SM: Employers originally banned telephones for same reason, that they would kill productivity. Ditto web. Now SM. #hcsm
  9. bacigalupe
    bacigalupe @shrinkraproy @HealthSocMed are you making a distinction between exempt and non-exempt employees? Big difference #hcsm
  10. Roy fromShrinkRap
    ShrinkRapRoy @bacigalupe Great point! As an exempt employee, when am I ever really "off"?
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T1.5 Fact or Myth: Social media content published by employees on work or personal accounts is automatically the property of the employer
  1. danielg280
    danielg280 Myth mostly but emplyers own stuff created "w/in the scope of emplymnt" #hcsm
  2. Patrick Mann
    patrickmann Big concern for corps is info leaking out through SM. Company is liable for employee actions. #hcsm
  3. danielg280
    danielg280 thus, If it's your job to do it, could be owned by employer, even if personal acct or equipment. #hcsm
  4. David Harlow
    healthblawg T1.5 Classic work for hire rule; not unique to SoMe - Matter for contractual negotiation #hcsm
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2. Back to Law School Basics

T2.1 Are social media tools like Twitter, FcBk, YTb redefining what constitutes intellectual property?
  1. Mark Scrimshire
    ekivemark #hcsm Put the patient at the center -They choose/own/control/delegate - seems like it simplifies a lot of complexities in HC.
  2. danielg280
    danielg280 t2.1 Prob not. File sharing was bigr challenge and hasnt caused sea change yet #hcsm
  3. Christian Sinclair
    ctsinclair T2.1 Oh yes. Check out some legal blogs for great posts on "Who owns your LinkedIn contacts?"
  4. Carmen Gonzalez
    crgonzalez T2.1>> That's where I think your Terms of Use can help guide employees #hcsm
  5. David Harlow
    healthblawg T2.1 Old rules like "fair use" might not seem as fair when the "use" is so instant and widely disseminated; law always plays catch-up #hcsm
  6. Nick Dawson
    nickdawsonhc Great point--> @sarahzaenger T1.5 Myth. no one can 'own' social media-- it's just out there #hcsm
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T2.2 Can you copyright a "Tweet" or a "Wall Post" in Facebook? -
  1. danielg280
    danielg280 t2.2 Prob too short to be copyrightable, plus (don't shoot me) not enough creativity per copyright law. #hcsm
  2. Jen S. McCabe
    jensmccabe @HealthSocMed #hcsm - can't copyright tweet yet. For IP, suggest this method: 1. creative commons info in profile, blog, facebook. 2. record
  3. David Harlow
    healthblawg #hcsm T2.2 Twitter TOS says Twitter asserts no claim of copyright, belongs to ac... Read More:
  4. danielg280
    danielg280 The rare tweet that's pure creativity could be (eg haiku), most are not. Good article: #hcsm
  5. HealthSocMed
    HealthSocMed @healthblawg and @danielg280 - Can I put a "c" with a circle next to my Tweets or Wall Posts? #hcsm (TS)
  6. Mark Browne
    consultdoc RT@chrisboyer @drval This type of conversation would work great in Google Wave...#hcsm #hcsm
  7. Carmen Gonzalez
    crgonzalez T2.2 Under the Commons, and even under Twitter's rules, a tweet belongs to the owner and can be RT'd w/ author's consent #hcsm
  8. danielg280
    danielg280 @HealthSocMed You can put the circle C, but it won't affect whether you actually have a copyright #hcsm
  9. danielg280
    danielg280 Actually, you can't own ideas unless it's patentable (which is a very high standard) copr. protects only creative xpression, not ideas #hcsm
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3. Best Practices

T3.1 What are the issues with *encouraging* or soliciting patient testimonials on a hospital branded social media account?

  1. Christian Sinclair
    ctsinclair T#: Had potential client worried about employees or patients saying" Dr. Smith is the BEST doctor!" #hcsm
  2. danielg280
    danielg280 T 3.1, Generally this is fine, so long as its voluntary and the patient signs a hipaa compiant auth #hcsm
  3. danielg280
    danielg280 Key is to make sure patient really understands what they're getting into. Don't want to have them surprised they're on network tv #hcsm
  4. chrisboyer
    chrisboyer Re T3: why would HC providers attempt to encourage patients to participate on SM accounts? That's against what SM is all about! #hcsm
  5. danielg280
    danielg280 Generally claims of "best" are puffing, and ok to say without support. #hcsm
  6. David Harlow
    healthblawg 3.1 Has to be voluntary, authzn needed too #hcsm
  7. Stephanie Thum
    stephaniethum @danielg280 So voluntary, unsolicited online pt testimonials are ok, but only if the person offering the testimonial signed a release? #hcsm
  8. danielg280
    danielg280 May not need an auth if only allowing a forum for them to do it. May need an auth of directly soliciting #hcsm
  9. Ed Bennett
    EdBennett So it's OK if patient shares happy story on any other blog, but if they post to the hosiptal blog they need a signed release? #hcsm
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T3.2 Any special issues when a hospital doc tweets vs. hospital employee who is not a doc? Personal vs. corp branded Twitter acct matter?

  1. Mark Browne
    consultdoc I have officially reached information saturation. I will enjoy reading the summary later. #hcsm
  2. Mark Scrimshire
    ekivemark @mkmackey #hcsm Cos have rules for communicating in co name.Most can be applied to SM as just another channel. Not sure more rules needed
  3. Ed Bennett
    EdBennett @jensmccabe "control" social media? That just makes me laugh. Only the old and clueless think that way. #hcsm
  4. David Harlow
    healthblawg #hcsm T3.2 Clinical communications not OK unless between clinician and establish... Read More:
  5. danielg280
    danielg280 t3.2 Docs and nurses generally can't practice med across state lines. Need to be esp. careful to not cross into pract med. #hcsm
  6. Rebecca K Weingarten
    coachkiki @HealthSocMed Perhaps personal accounts vs. work accounts - many gov. employees tweeting have "this is not work" or something on acct. #hcsm
  7. Brian Ahier
    ahier RT @chukwumaonyeije: @drval @Dr_Bob #hcsm Yes. This would be great on BlogTalkRadio @2healthguru
  8. Craig Stoltz
    craigstoltz RT @HITshrink: Hmm, I haven't seen any ads: "Has this happened to you? Ur doc twittered ur surgery w/o consent?" 1-800-LAWYERS. #hcsm
  9. Don Sheppard
    donshep @danielg280 That an interesting one T3.2 if a provider in MA recommends something to a "follower" in CA is that prohibited #hcsm
  10. Carmen Gonzalez
    crgonzalez T3.2 There's the public expectation that what a doctor says can be construde as a medical opinion; not so with non-doc employee #hcsm
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T3.3 What are the rational boundaries for allowing posting of negative comments on hospital social media account? What's OK to approve, what's not? T3.3-1 Any legal scenario where blocking a negative comment would not be the best course of action?

  1. David Harlow
    healthblawg #hcsm T3.3 To me, less legal, more intestinal fortitude issue. In this case (ne... Read More:
  2. HealthSocMed
    HealthSocMed @danielg280 and @healtblawg T3.3 What abt those pesky negative comments in social media toward providers, practitioners, payers? #hcsm (TS)
  3. Jen S. McCabe
    jensmccabe @HealthSocMed Allowing posting of critical comments required for improvement. Abusive/trolling take yer pick of best practice TOS. #hcsm
  4. danielg280
    danielg280 @HealthSocMed If from non-patient, can pursue for libel if untrue. If patient, Hipaa ties your hands in public forum #hcsm
  5. Don Sheppard
    donshep T3.3 Negative comments are a way of life whether waiting room bitching or on SM not much different #hcsm
  6. David Harlow
    healthblawg T3.3 tries to get pts to agree in advance not to post negative rvws; I think that's inappropriate #hcsm
  7. Nick Dawson
    nickdawsonhc @danielg280 hands tied how? Can you respond Bank Of America style "can't answer here, but here is my number, call me... ?
  8. Don Sheppard
    donshep T3.3 Lawyers are dealing with the same issue aren't they negative comments in SM?
  9. Gloria O'Connell
    gocatallina What if patients want to videotape their entire hospital experience and put it on YouTube? What are there boundaries? #hcsm
  10. Christian Sinclair
    ctsinclair @donshep Have been following legal sm circles but not seen much chatter about this. Lawyers have ethics guideline re: marketing self #hcsm
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T3.4 What about targeted use of SocMedia tools by covered entities & employees toward specific racial, ethnic, gender communities offering treatment? T2.4-1 E.g. HIV/AIDS testing offers are very effective at dating web sites, esp when offer is made by a trusted member of community.

  1. candacee116
    candacee116 @HealthSocMed this might be the best way to reach some vulnerable groups we would not see/hear from otherwise #hcsm
  2. Roy fromShrinkRap
    ShrinkRapRoy My hosp is opening OB in Fall. An encouraging them to open up Tw/FB/Flickr. Those new moms wont like no access. #hcsm
  3. Jen S. McCabe
    jensmccabe There are Twitter conventions we can try to 'activate' groups without personal identifiers. #getupandmove. #don'tsmoke #hcsm
  4. David Harlow
    healthblawg #hcsm T3.4-1 HIV is a whole other story. Many/most states have pt privacy laws ... Read More:
  5. Sarah Skiba
    sarahskiba #hcsm What protects patients from hackers or stalkers posing as their health care professionals?
  6. Nick Dawson
    nickdawsonhc @shrinkraproy OB is our first/most interested service line as well #hcsm
  7. Don Sheppard
    donshep T3.4 I know the hospital I volenteer at is look to social media to keep in touch with gastric bypass/band patients
  8. Mark Dimor
    MarksPhone @HealthSocMed yes target specific demographic groups with objectives and strategies and outcomes. Use SM as one tactic #hcsm
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T3.5 Is social media message traffic on a provider/employee acct using a provider network subject to HIPAA data capture/retention requirements?

  1. David Harlow
    healthblawg T3.5 HIPAA covers PHI. Social media should not include PHI except in ltd circumstances (w consent) #hcsm
  2. MacArthur Obgyn
    macobgyn @shrinkraproy For the OB people Check out Macarthur OBGYN on Facebook and see what we are doing. #hcsm
  3. Leon Palmer
    leonpalmer Think anyone else would watch if we turned this tweetchat feed into a YouTube video? #hcsm
  4. MacArthur Obgyn
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T3.6 A patient (identifies self as a pt of specific hospital) makes a public comment about an inaccurate bill on a social media account. T3.6-1 Can the hospital respond in the same forum? Can the hospital respond with helpful details? T3.6.2 Can the hospital set the record straight if the patient representation is grossly inaccurate or misleading?

  1. Jen S. McCabe
    jensmccabe @HealthSocMed re: hospital setting record straight if patient account 'grossly inaccurate' exhibit A: Glenn Beck (bleck). No, counter. #hcsm
  2. HealthSocMed
    HealthSocMed @danielg280 and @healthblawg T 3.6 - pt tweets about a bill, "too much", "not right", "outrageous" #hcsm (TS)
  3. Jen S. McCabe
    jensmccabe Slander, libel will somehow make their way into our precedents for rating/ranting using social media sites and tools methinks. #hcsm
  4. Stephanie Thum
    stephaniethum @HealthSocMed T3.6.2 Interesting q b/c even if they *could* set the record straight, should they, publicly, for face-saving reasons? #hcsm
  5. danielg280
    danielg280 Provider can't respond publicly unless patient auths in writing. response almost always will entail the disclosure of PHI #hcsm
  6. Brian Ahier
    ahier #hcsm @HealthSocMed pts tweeting about bill needs to be immediately personally responded to (just like other business)
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T3.7 A 3rd party posts via Twitter, Facebook, MySpace: “My grandmother has been waiting in the ER for hours, sucks!” T3.7-1 Can the provider respond to these posts via social media since the patient did not initiate the posting? What if patient had posted instead?

  1. David Harlow
    healthblawg T3.6.2 Either without PHI, or w PHI if consent is given; can't assume/imply consent & w unhappy camper, not likely, so keep it generic #hcsm
  2. Nick Dawson
    nickdawsonhc We've addressed several complaints in comments in local paper's site. (was a top google hit for me). Asked concerned pts to call me #hcsm
  3. Marie Whitehead
    Miz_Marie 50-60 people on chat- way too many comments to follow in one sitting but great topic/posts on Health care and Social Media #hcsm
  4. candacee116
    candacee116 I say respond immediately to someone upset with you and take control to make it right-show you are aware and willing to fix problems #hcsm
  5. Christian Sinclair
    ctsinclair RE T3.7 - if a family member intiated and named the provider,, the provider/org should be able to communicate back without ID of pt #hcsm
  6. Steven Daviss MD
    HITshrink @danielg280 "Provider can't respond publicly" [well, they could make a general comment about how they manage xyz situations. #hcsm
  7. Markle Needham
    mneedham @HealthSocMed re: T3.7 “... waiting in the ER for hours... ” :: happens to us regularly - working on response protocol now. #hcsm
  8. David Harlow
    healthblawg #hcsm 3.7.1 1. Send a human being to the ER empowered to cut red tape and post a... Read More:
  9. danielg280
    danielg280 @HITshrink AGreed. That's the one way to do it. Still have to be careful not to disclose something patient specific #hcsm
  10. Mark Scrimshire
    ekivemark @HealthSocMed #hcsm T3.6.2 This prob exists in many other industries. Don't get in a cat fight. Be reasonable. undetones will come through
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T3.8 A patient initiates a private email or public social media communication to a doctor/provider that is not solicited and contains PHI. T3.8-1 What's the best way to handle the private email or the public social media conversation?

  1. Markle Needham
    mneedham @HealthSocMed re: T3.7 “... waiting in the ER for hours... ” :: response will involve personal delivery of flowers - not social media #hcsm
  2. MacArthur Obgyn
    macobgyn @HealthSocMed T3.8-1 Great question. Should the provider not respond? #hcsm
  3. Christian Sinclair
    ctsinclair RT @donshep A good rule is to use your profile URL to have a FAQ about how you will interact on twitter. "Good tip" #hcsm
  4. GraftFinder
    GraftFinder Explain the "openness" of the comm plateform in PLAIN language to the patients and have them sign that they understand risk/reward #hcsm
  5. David Harlow
    healthblawg T3.8 Email and other elec comm OK w est pts; "cold call" needs friendly but firm response instructing pt on how to est that rel #hcsm
  6. chrisboyer
    chrisboyer Wish I could spend more time on #hcsm, but will have to check back on the transcript later. Will blog my thoughts:
  7. Patrick Mann
    patrickmann T3.8 I have always recommended our users remove any unwanted PHI information when replying to a patient via email. #hcsm
  8. GraftFinder
    GraftFinder I would much rather talk to a Dr by email personally, unless I was very sick. #hcsm
  9. danielg280
    danielg280 HIPAA actually does not mandate encrypted email. Doc can use regular email to correspond with patient and not violate law #hcsm
  10. danielg280
    danielg280 Need to think thru whether it's a good idea: will email be attended if pt emails time sensitive, will info get into med record, etc #hcsm
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Wrap Up

  1. Steven Daviss MD
    HITshrink @StevenBarley So right ... this is a convo that must be reread later to digest, reflect. [will add to #hcsm
  2. HealthSocMed
    HealthSocMed Big thanks to David Harlow and Daniel Goldman for their time tonight at #hcsm. Virtual applause/cheering! (TS)
  3. HealthSocMed
    HealthSocMed And many thx to all who participated in this experimental format. Obviously, lots of lessons learned. Thanks for your patience. #hcsm (TS)
  4. danielg280
    danielg280 Thanks everyone for the lively chat. Lots of fun, tho what little hair I have is standing on end and I'm sweating. . . #hcsm
  5. Steven Daviss MD
    HITshrink @ekivemark Coveritlive used on my blog if you want some recap of tinight. [VERY COOL!] #hcsm
  6. Dana
    danamlewis if you have comments, suggestions, and/or ideas for a future #hcsm, please feel free to DM @danamlewis @healthsocmed or @tstitt
  7. David Harlow
    healthblawg @patrickmann HIPAA and Son of HIPAA -- some of the questions raised by ARRA changes to law #hcsm
  8. David Harlow
    healthblawg Thank you all - and I look forward to continuing the conversation here, there and everywhere #hcsm
  9. Kevin O'Toole AC4ALD
    otoole4info Look for transcript in the next 24 hrs I'll Tweet when it's complete! #hcsm
  10. Dana
    danamlewis wonderful volunteer @otoole4info is compiling a transcript, & i believe @klxmedia is providing some overviews (in addition to others) #hcsm
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