Thursday, August 14, 2008

The HIPAA in the Room

I've been a little gun-shy of my posts on Hope for Pandora recently. It seems as though a Seattle medical version of big brother may be watching... watching blogs. One of my friends - a blogging friend and real-life friend - was asked to remove material or shut his blog down because a compliance officer at a hospital where we train was concerned that certain of his posts violated patient confidentiality. Check out Noel's blog, aptly named, Constructive Procrastination.

I have sought to maintain the integrity of my writing by anonymizing my stories or asking permission of my patients to write about them or folding several patients into one pseudo-fictional account in the interest of telling a good story. Each of these techniques fall within the guidelines of the Healthcare Blogger Code of Ethics. What bothers me is that my friend had also observed these behaviors in his writing.

What bothers him is the manner in which he was approached. I'll let him tell the story in his own words, which started a couple of weeks ago. It seems as though our hospital wants to have more control over what gets into the public domain from experiences inside the hospital. Since I have vague aspiration to publish some of my own expereinces in a format more commercial than a blog, this got my ears up. After all, I already write for lunch money over at The Differential. I contacted folks in the community relations department before starting that gig - I wonder if someone else is trying to enforce some element of control or oversight on writers like me.

I think that my hospital administration is a little out of its league right now. One in ten Americans have tried their hand at blogging or something like it. I'm betting that health professionals are no exemption to that. I'm a little worried about an Orwellian move here. Why isn't the Health Care Blogger Code of Ethics or something like it good enough?

The compliance office may be full of friendly faces and good intentions, but do they really know what they are trying to do? Fortunately, my friend has volunteered to provide a voice for us bloggers.

4 comments:

Noel Hastings said...

Thanks for jumping into the fray here Thomas. I am also concerned but I hope that by being a part of the process it will help us bloggers have more say in the process. At first I was very concerned for my own welfare more than anything. I had heard rumors of expulsion. Luckily our new Dean soon reassured me it was not going to come to that. I have had good feedback from everyone regarding my blog so I think that this too shall pass, but hopefully we will come out the other end with something even more solid and substantive to point to in the future when people raise concerns.

I, like you, have some possible future aspirations to write my experiences in a format more "biodegradable", which would suit my writing quite nicely I think. Now is a great time to get oriented to all the legal and political pitfalls that writing and medicine can entail.

One item that was brought up in our discussion was the use of an anonymous blog and how that is one of the most effective means of protecting patients and hospitals. I was surprised that the compliance officer was supportive of this idea in general. We all know what happened to Dr. Flea! Anonymous is not guarantee that you will stay that way. I also found in my past attempt at anonymous blogging that I was more careless, more negative and in general writing stuff that I felt reflected more negatively on me as writer, which is why I decided to stop that blog and associate my name with my words. Take responsibility for them. After this event though... I may return to anonymous blogging...

thomas said...

I have had the pseudonymous/ anonymous discussion before and still feel that being totally out there is the best way for me to blog. I am more uncomfortable cloaking myself than being up front about the context from which the stories, cases and learning points were drawn.

I am quite interested to hear about the compliance folks' interests. I wonder if this wheel has been invented before...

BenMc said...

As someone who's struggled with the questions of online anonymity myself, best wishes for working out a solution that keeps everyone (or at least someone) happy. For universities we have "FERPA" considerations to protect student privacy. I keep a degree of anonymity just enough to make it a little hard to find out who I am from my blog: but since I want to talk about it when my lab publishes something, it's very easy to figure out who I am from my blog. The wall I've put up is that you can't find my blog from generically knowing my name. Sort of a one-way mirror. That's what works for biochem professors, at least.

I have removed one post in the past because of privacy concerns, but it was my own personal privacy!

Maybe it's why I blog about science so much: no issues of confidentiality if it's published in Nature.

Drugmonkey said...

i think this will end up being a little more than just fear of the unknown. that intellectual property crap is going to be something institutions use for-reals if you ask me...