Buzz e-sante

L'observance thérapeutique est un enjeu majeur pour l'ensemble des acteurs de la santé. 

De nombreuses études montrent que beaucoup de patients n'observent pas correctement leur traitement, y compris dans des pathologies graves. Une journée réunira des experts lors d'une conférence à Paris le 2  octobre 2014

E-santé : google calico - Lancement du site CALICO de Google.. le géant de Mountain view confirme ses ambitions en E-santé après Novartis et Baseline study

Patients can complain about their medical experiences on Yelp, snap photos of doctor's offices for their Instagram account, and even post pictures of a doctor conducting an exam to Facebook, all "invasions" of privacy that would be actionable if it were a doctor posting about a patient.

"There are important issues when it comes to your online reputation, such as the dissemination of less than accurate information about one's practice or professionalism," said Don S. Dizon, MD, medical oncologist in the Gynecologic Oncology service at Massachusetts General Hospital's Cancer Center, and past chairman of the Integrated Media and Technology Committee for the American Society of Clinical Oncology.

"Clinicians and other professionals certainly have a right to be concerned, and protecting their reputation is a subject of much interest in medicine," Dizon said.

Yelp is a prime example of the power patients wield over a doctor's online reputation. S. Steve Samudrala, MD, of America's Family Doctors, described how drug-seeking patients who have been turned away by his practice will go on Yelp to leave negative, erroneous feedback. "Yelp should not be used for medical reviews. We can't defend ourselves because of HIPAA," said Samudrala.

Bryan Jick, MD, of Fair Oaks Women's Health, had a much different experience with a negative Yelp review. A person who was not even a patient was upset that a doctor in his practice did not respond to an unsolicited e-mail and left a one-star review for the doctor. "I went on Yelp and I flagged the review for being inappropriate," Jick said. Yelp then took down the inaccurate review.

While clinicians cannot control what is said about them via social media, they certainly have a say about what goes on in their own offices and exam rooms. "Doctors should establish photo policies and privacy expectations for their offices," said Joseph Wesolek, Web and Social Media Specialist for Beaumont Health System.

"Having an open, amicable relationship with your patients is always the way to go," Wesolek said.

But if a doctor's privacy is violated, their options are limited. "There isn't much recourse for a physician, barring some pretty egregious behavior on the violator's part," said Charles Seife, professor of journalism at NYU.

"Once there's a breach of your personal privacy, it's often much more severe than it used to be because that information is so much more easily found through search engines and other tools," Seife said.

For those healthcare professionals who do want to utilize social media as a marketing or communication tool, patient privacy is still always the chief concern. To make matters more complicated, HIPAA was not exactly drafted for this new digital age. "You won't be seeing do's and don'ts for Instagram anytime soon, but, in practice, all of the HIPAA rules still apply," said Wesolek.

Vandna Jerath, MD, of Optima Women's Healthcare in Parker, Colo., has embraced social media as part of her practice. She has 10 different social media accounts, including a personal and professional Facebook, Twitter, Pinterest, and Google+ , as well as a LinkedIn and YouTube account. Jerath likens her social media interaction with patients to a cocktail party. "If I was at a party and someone told me they had tennis elbow, I wouldn't start treating them right there," Jerath said.

Jerath believes transparency is the key for healthcare professionals to use social media effectively. She had a lawyer draw up a HIPAA-compliant patient consent form for her Facebook page when she first opened her practice in 2010, and has yet to encounter any complaints about patient privacy when photos of new mothers and their babies are posted.

She added that patients will actually message her if they do not see their submitted photos on the page. "If I miss a post with a patient's baby, they get upset," Jerath said.

Farris Timimi, MD, a cardiologist at the Mayo Clinic and medical director of the Mayo Clinic Center for Social Media, sees clear benefits to doctor/patient interaction on social media. "From an enterprise perspective, our greatest tools for engagement are our employees," said Timimi.

He also believes the use of social media can be part of an effective coping strategy for certain patients. "Sharing is a part of a patient's recovery, particularly for those who find that their disease isolates them by geography," Timimi said. "Partnership and peer-to-peer support can be found readily online."

But as social media penetration continues at a rapid rate, privacy issues are likely to keep evolving. "There's been a shift in what people consider private and what they're willing to share, and it's hard to keep up with what patients will find problematic and what they won't," said Seife.

When facing this uncertain landscape, Dizon offers perhaps the only solution applicable to doctors and patients alike. "When in doubt, don't post," Dizon said.

The waves of technological changes coming towards us will generate new possibilities as well as serious threats to medicine and healthcare.

Tech-savvy patients and family members are working with glucose monitors for diabetics and other medical devices to make them more useful.