Running head: SOCIAL MEDIA IN HEALTHCARE
Social Media in Healthcare: How Can It Hurt and How Can It Help
Kelli Richardson
Auburn University School of Nursing
NURS 4910
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Abstract
Social media is everywhere in healthcare today so nurses and physicians need to be
informed about the benefits and dangers that come with it. Social media comes in many forms,
from websites and blogs to personal networking sites. The Health Insurance Portability and
Accountability Act (HIPAA) put laws in place to protect patients and healthcare providers from
breeches in confidentiality. Nurses and doctors need to be aware of the dangers of possibly
breaking these laws and the ways in which to legally use social media. The benefits of social
media range from wellness promotion, evidence-based care, and support groups for patients,
which can all lead to an improved quality of care. Increased communication among physicians
allows for review of the latest journal articles, conference presentations, and research findings.
Facebook pages are allowing for increased nurse recruitment and retention rates, increased
donations from patient success stories, and a heightened focus on health promotion and disease
prevention. Online care plans are available for nurses to include patients in their planning so as
to acknowledge each patient’s uniqueness and increase compliance with interventions. Nurses
and healthcare providers have a passion for helping others, and they can share this passion with
other members of the healthcare team by engaging in these social mediums. In order for nurses
to bring about change and improve patient care, social media needs to be incorporated into
healthcare in an ethical and legal manner.
Key words: social media, healthcare, nursing, confidentiality, education, health promotion
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Social Media in Healthcare: How Can It Hurt and How Can It Help
With the abundance of social media outlets available today, it is no surprise that the
healthcare industry has taken a liking to such resources. With websites like Facebook, Twitter,
WebMD, and YouTube, patients and providers alike have turned to the Internet for help. Social
media offers many benefits surrounding the healthcare field, including wellness promotion from
hospitals, support groups for patients, and access to evidence-based practice for providers
(Richter, Muhlestein, & Wilks, 2014). Unfortunately, alongside these benefits are risks that
healthcare providers need to be aware of before engaging in social media. To combat these risks,
confidentiality laws from the U.S. Department of Health and Human Services (USDHHS) are
put in place to protect both patients and providers’ privacy (Lachman, 2013). The purpose of
this paper is to warn nurses and physicians about the risks associated with social media but also
to encourage its use as an effective tool in advancing healthcare and educating the public.
Social Media
The term social media refers to a group of online software tools that allows for
interaction, composition, and development of online content by any user who has web access
(Lachman, 2013). Well-known sites typically used by those in the healthcare arena include
Facebook, LinkedIn, and Twitter, but many more exist for both public and private use. Social
media has a huge impact on the way people and organizations communicate with each other, and
the statistics for use are astounding. Facebook reportedly has more than 750 million active users,
and Twitter has reached almost 555 billion users (Lachman, 2013). Surprisingly, these statistics
are not limited to the millennial population, those born between the years of 1982 and 2004.
Baby boomers are shown to be the fastest growing age group of people using social media, with
over 51% using some form on a regular basis (Lachman, 2013).
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Recent surveys have shown that approximately 60% of patients now seek information
and support from online sources, and healthcare information inquiry is now the third most
popular online activity, behind Internet search and email. In a survey of 3,014 participants, onethird reported going online to research a medical condition, for either himself or a family
member. A nation-wide survey showed similar statistics with more than 35% of the United
States population using the Internet for health-related searches (Lachman, 2013). With numbers
like these, it makes sense for healthcare providers and facilities to have a presence in social
media. However, before jumping online and posting about the most recent patient that came
through the Emergency Department, it is important for doctors and nurses to understand the
proper use of these technologies.
How Can It Hurt
Prior to getting involved with multiple social media websites, healthcare providers need
to be aware of the challenges that social media can cause regarding privacy and professionalism.
Due to the unregulated and unpredictable nature of the Internet, the risk for accidental selfdisclosure and confidentiality breech will always exist (Lachman, 2013). Fortunately, the Health
Insurance Portability and Accountability Act (HIPAA), created by the U.S. Department of
Health and Human Services (USDHHS), introduced a term known as protected health
information (PHI) in order to protect information and prevent privacy ethical violations. Two
ways exist in which nurses can include patient information in social media posts and still comply
with HIPAA regulations. The patient can sign a consent form, allowing PHI to be used socially,
or the information can be de-identified (Lachman, 2013). De-identified information neither
identifies nor provides any possible way to identify an individual. In order to properly deidentify a patient, specific identifiers of the patient, patient’s relatives, household members, and
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employers must be removed. If referring to a specific patient, all identifiers must be changed,
including gender, age, location, time frame, and diagnosis, in the case of rare diseases (Lachman,
2013).
One issue that has been getting a lot of attention recently is incidences of photographs
being taken of patients. A study done in Australia found that 20% of clinicians used smart
phones to take pictures of patients (Douglas, 2014). The author of the study, Kara Burns,
revealed that it is fairly common for photos to be taken of interesting cases, but whether or not
the images are shared determines the need for ethical and legal ramifications. Sharing an image
is only considered ethical if it is shared with another clinician for diagnostic purposes. If the
image is shared with another clinician who is not treating the patient or if it is shared with no
clinical relevance, then an ethical or legal breech may be present (Douglas, 2014). Photos are
considered a highly confidential piece of data and must be stored in accordance with the rest of
the patient’s health data. Burns acknowledges that it is not the actual device, such as camera or
smart phone that is the problem. As long as the photos are stored correctly and deleted from the
device, or are used in accordance with the signed consent, then the use remains ethical (Douglas,
2014). While social media used in the healthcare arena can be dangerous, it can still be used as a
tool to advance these medical professions and to educate the public. Nurses need to educate
themselves with the appropriate knowledge of HIPAA and PHI regulations so that social media
can be used safely to make a difference in the nursing profession and in patient care.
How Can It Help
For all the dangers that social media can pose to the healthcare industry, it can also be a
valuable tool in reaching today’s technologically advanced consumers. Social media has many
benefits in the healthcare arena for hospitals, patients, and providers alike. If used properly,
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social media can be an effective means for impacting health, providing patient education, and
strengthening the nurse-patient relationship (Henderson & Dahnke, 2015).
Among hospitals and other healthcare facilities, Facebook is the mostly widely used form
of social media (Richter et al., 2014). Hospitals use Facebook as a means of providing education
to their consumers, acknowledging their staff, and sharing news about hospital awards.
According to a survey done in 2014 about United States hospitals and social media use, the
percent of hospitals using Facebook was significantly higher among large, urban, nonprofit
hospitals and those hospitals affiliated with a university or health system (Richter et al., 2014).
These particular hospitals showed a heightened focus on health promotion and disease
prevention. This type of wellness promotion by hospitals helps healthcare organizations align
their marketing efforts with their mission (Boyer, 2011). Since most hospitals already have
wellness programs in place, such as patient education programs, flu and vaccination clinics, and
health fairs and screenings, these social media outlets allow hospitals to reach a wide audience at
a relatively low cost compared to traditional forms of advertising (Richter et al., 2014). Other
websites, like LinkedIn or hospital-specific blogs, have been shown to improve nurse recruitment
and retention rates as well as to increase donations to facilities after posting about patient success
stories (Richter et al., 2014).
In a 2011 article written from a personal experience as a patient in an Intensive Care
Unit, Chris Boyer argues that social media is natural for patients. As aforementioned, more than
35% of the U.S. population has consulted the Internet for a health condition of some kind. Not
only does social media provide patients with factual information regarding their disease or
condition, it also provides a means for communication among other patients. Patients are getting
online to interact with others who share ailments or have similar concerns (Squazzo, 2010).
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Emotional support carries a significant power in health, and social media is serving that purpose
for many people (Mewborn, 2013). Patients are now able to connect with others who have rare
conditions who never had the opportunity previously to connect. These support groups can
provide educational opportunities such as promoting healthy lifestyles for chronic conditions or
teaching about the importance of adhering to medication regimens (Henderson & Dahnke, 2015).
Patients need to feel that they are being heard and, in doing so, can benefit greatly from hearing
others’ stories.
Although online support groups can connect patients with others who share similar
conditions, it is also important to remember that each patient is different and their plan of care
should be as well. Knowledgeable use of social media can allow nurses and other healthcare
team members to plan care that caters to a patient’s uniqueness, allow the patient to contribute to
the plan of care, and ensure that the plan is deemed acceptable by the patient (Henderson &
Dahnke, 2015). The nurse-patient relationship is a key element in healthcare and maintenance,
and social media can help strengthen this relationship by actively involving the patient in his care
planning. In a 2014 article published by The Nursing Standard, Teresa Chinn talks about the
power of social media for nurses in particular. Chinn coordinated a weekly chat on Twitter using
#WeNurses to discuss professional issues that she felt as an agency nurse (“The power of social
media,” 2014). The Department of Health has since adopted the platform to get feedback from
nurses and to launch consultations from nursing practice. Chinn believes the 14,000 health
professionals currently following @WeNurses have provided endless benefits for patients (“The
power of social media,” 2014). Topics such as diabetes, renal care, nursing leadership, and
clinical guidelines are among the many seminars that Chinn delivers weekly to her many
followers. This nurse-specific blog is one of the many ways in which social media can benefit
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nurses who have a desire to improve patient care. Nurses have a strong passion and can share
that passion online to bring about change and improvement in patient care (“The power of social
media,” 2014).
Social media is helpful not only to nurses, but to other members of the healthcare team as
well. Physicians have said that social media improves the quality of care delivered to patients
because of the wealth of knowledge that is available to them. Attending and resident physicians
can discuss the latest journal articles, conference presentations, and researching findings with
colleagues around the world (Mewborn, 2013). This increased communication among healthcare
providers allows for the most evidence-based practice to be integrated into the current healthcare
system and for new and noteworthy treatments to be tried nation-wide. With the most up-to-date
care being provided, these patients will receive a higher quality of care than those patients whose
physicians do not have access to this wealth of information (Mewborn, 2013).
In my research surrounding social media in healthcare, it has become clear to me that
nurses have an obligation to protect patient privacy and confidentiality as well as to provide
education and quality care to those who need it. Social media is everywhere in our world today,
so it is important for members of the healthcare team to understand how to use it effectively.
Although there are dangers to using social media in this industry, such as an accidental breech in
confidentiality, there are also significant benefits that can lead to improved patient care.
Increased communication among physicians and nurses around the world, wellness promotion on
websites and blogs, and health-related support groups for clients can make drastic differences in
the care of our patients. When used properly and with thoughtfulness, social media can be an
excellent method for reaching today’s technologically savvy population and for promoting
healthy lifestyles to our patients.
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References
Boyer, C. (2011). Social Media for Healthcare Makes Sense. Frontiers Of Health Services
Management, 28(2), 35-40.
Douglas, K. (2014). SOCIAL MEDIA. Australian Nursing & Midwifery Journal, 22(1), 24-28.
Henderson, M., & Dahnke, M. D. (2015). The Ethical Use of Social Media in Nursing Practice.
MEDSURG Nursing, 24(1), 62-64.
Lachman, V. D. (2013). Social Media: Managing the Ethical Issues. MEDSURG Nursing, 22(5),
326-329.
Mewborn, A. (2013). Social media, a tool to use in healthcare. Industrial Engineer: IE, 45(5),
24.
Richter, J. P., Muhlestein, D. B., & Wilks, C. A. (2014). Social Media: How Hospitals Use It,
and Opportunities for Future Use. Journal Of Healthcare Management, 59(6). 447-460.
Squazzo, J. D. (2010). Best Practices for Applying Social Media in Healthcare. Healthcare
Executive, 25(3), 34-39.
The power of social media. (2014). Nursing Standard, 28(36), 63.