Health IT’s social media nightmare

August 27, 2014 in Medical Technology


Few healthcare IT policies these days are as delicate, sensitive and potentially emotionally explosive as efforts to restrict or regulate employee social media activity. And yet hospital hierarchies are routinely stepping on these political minefields as providers try to protect their reputations.

Consider a recent incident at the 2,478-bed New York Presbyterian Hospital.

An ER nurse posted a photograph of a trauma room – no staff or patients were in the picture – after caring for a man who had been hit by a subway train. The caption: “Man vs. 6 train.” The image simply showed a room that had seen a lot of action moments before. The veteran nurse was fired after the incident, according to an ABC News report, not because she had breached hospital policy or violated HIPAA, but, as she put it: “I was told I was being fired for being insensitive.”

This legitimately raises key issues around what a hospital’s social media policy should be. This specific incident, though, appears to be an impressively poor choice for the hospital to have selected to make its stand. First, there really was no privacy issue at play. The photo shows nothing more than a slightly messy trauma room. The caption is vague and is hardly worse than a police officer posting a car accident image, with a note warning people against drinking/texting while driving. (To be precise, the injured car would be recognizable to the patient along with friends and family, especially if a license plate were visible, whereas a generic trauma room photo isn’t.)

An even bigger problem with using this incident is that the nurse, Katie Duke, didn’t even take that photograph. It was taken by a staff doctor and the doctor had posted it on the doctor’s Instagram page. Nurse Duke had merely reposted it. The consistency killer? The doctor “was not reprimanded,” ABCNews reported. To be fair, it’s not clear whether the doctor’s post included the “Man vs. 6 train” comment. Given that it appears that the comment – as opposed to the image – is the trigger here, the hospital’s disciplinary process may or may not have been inconsistent.

Let’s get back to the social media policy issues. I would hate to have to issue a concrete definition – acceptable to our friends in Legal – of “sensitivity.” What if there had been no image and the nurse had simply said something like “A grim reminder at the ER today about how dangerous and deadly subways can be. Don’t take any chances – ever.” Is that insensitive? And if not, how is it meaningfully different than what Duke reposted? She specified the subway line, which, by itself, isn’t insensitive nor especially revealing. And she used an image of the trauma center, which showed nothing. Would it have made any difference had she posted a generic trauma center image from Google Images?

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