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Cited by 114Social Media in Health EducationThoreau and American LiteraturePrivacy, Security, and Data Protection

Protected health information on social networking sites: ethical and legal considerations

Open access
Thompson, Lindsay A, Black, Erik, Duff, W Patrick, Paradise Black, Nicole, Saliba, Heidi, Dawson, Kara·2011·Journal of Medical Internet Research
DOI 10.2196/jmir.1590PMC PMC3221358
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Abstract

BACKGROUND: Social networking site use is increasingly common among emerging medical professionals, with medical schools even reporting disciplinary student expulsion. Medical professionals who use social networking sites have unique responsibilities since their postings could violate patient privacy. However, it is unknown whether students and residents portray protected health information and under what circumstances or contexts. OBJECTIVE: The objective of our study was to document and describe online portrayals of potential patient privacy violations in the Facebook profiles of medical students and residents. METHODS: A multidisciplinary team performed two cross-sectional analyses at the University of Florida in 2007 and 2009 of all medical students and residents to see who had Facebook profiles. For each identified profile, we manually scanned the entire profile for any textual or photographic representations of protected health information, such as portrayals of people, names, dates, or descriptions of procedures. RESULTS: Almost half of all eligible students and residents had Facebook profiles (49.8%, or n=1023 out of 2053). There were 12 instances of potential patient violations, in which students and residents posted photographs of care they provided to individuals. No resident or student posted any identifiable patient information or likeness in text form. Each instance occurred in developing countries on apparent medical mission trips. These portrayals increased over time (1 in the 2007 cohort; 11 in 2009; P = .03). Medical students were more likely to have these potential violations on their profiles than residents (11 vs 1, P = .04), and there was no difference by gender. Photographs included trainees interacting with identifiable patients, all children, or performing medical examinations or procedures such as vaccinations of children. CONCLUSIONS: While students and residents in this study are posting photographs that are potentially violations of patient privacy, they only seem to make this lapse in the setting of medical mission trips. Trainees need to learn to equate standards of patient privacy in all medical contexts using both legal and ethical arguments to maintain the highest professional principles. We propose three practical guidelines. First, there should be a legal resource for physicians traveling on medical mission trips such as an online list of local laws, or a telephone legal contact. Second, institutions that organize medical mission trips should plan an ethics seminar prior the departure on any trip since the legal and ethical implications may not be intuitive. Finally, at minimum, traveling physicians should apply the strictest legal precedent to any situation.

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  • The public availability of information on patients and physicians represents a threat to privacy, with the potential for a negative impact on patient-physician relationships.

    “As previous research shows, the public availability of information on patients and physicians represents a threat to privacy [140-142], with the potential for a negative impact on patient-physician relationships [143,144].”

    From Dangers and Benefits of Social Media on E-Professionalism of Health Care Professionals: Scoping Review (2021) · cites this paper as [141]

    The Introduction and Results describe potential patient-privacy violations from medical trainees’ publicly available social-network profiles, supporting the privacy concern. The supplied passages and the additional passages retrieved from our copy do not establish a negative impact on patient–physician relationships; the citing sentence assigns that point to a separate citation group. (LLM, conf=0.82)

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  • The findings provide an important foundation for developing training on PSM in medical schools.

    “Given the increasing use of SM among medical students and health professionals and the concerns about unprofessional behaviors online (15, 50–56), these findings provide an important foundation for developing training on PSM in medical schools.”

    From Identifying social media professionalism competencies in Vietnamese medical students: a modified Delphi method (2026) · cites this paper as [53]

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2 of the 24 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. [2]Lampe C Ellison N Steinfeld C Changes in the use and perception of Facebook 2008 ACM Conference on Computer Supported Cooperative Work 2008 San Diego, CA, USA
  2. [14]Bradke AJ The Ethics of Medical Brigades in Honduras: Who Are We Helping? [master's thesis] 2007 Pittsburgh, PA University of Pittsburgh

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Authors
Thompson, L. A., Black, E., Duff, W. P., Paradise Black, N., Saliba, H., & Dawson, K.
Affiliations
  • University of Florida Health (US)
  • University of Florida (US)
Corresponding author
Thompson, Lindsay A
ORCID
Venue
Journal of Medical Internet Research
Publisher
JMIR Publications Inc.
Published
2011-01-19
Volume
13
Issue
1
Pages
e8
ISSN
1438-8871 (ISSN-L)
DOI
10.2196/jmir.1590
PMC
PMC3221358
OpenAlex
W2145918625
Cited by
114
References
24
Citations by year
2026: 2 · 2025: 1 · 2024: 1 · 2023: 3 · 2022: 1 · 2021: 8 · 2020: 9 · 2019: 10 · 2018: 1 · 2017: 10 · 2016: 5 · 2015: 13 · 2014: 22 · 2013: 10 · 2012: 15
FWCI
16.43
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Journal of Medical Internet Research (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • DigitalGeorgetown (Georgetown University Library) (submittedVersion)
Funders
University of Florida
Topics
  • Social Sciences › Health › Social Media in Health Education
  • Physical Sciences › Computer Science › Information Systems › Thoreau and American Literature
  • Social Sciences › Sociology and Political Science › Privacy, Security, and Data Protection
Keywords
protected health information, social networking sites, Facebook, patient privacy, medical students, medical residents, medical missions, privacy violations, professional ethics, legal issues
MeSH terms
Confidentiality, Cross-Sectional Studies, Developing Countries, Humans, Internship and Residency, Medical Missions, Physicians, Social Support, Students, Medical, Consumer Health Information

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