Managing Risks in Health 2.0

By Neil Versel

September 9, 2008 | TORONTO—Interactive media with user-generated content, often generically referred to as Web 2.0, has taken off in health care in the last couple of years. But with all the options and convenience that blogs, wikis, social networking sites, chat rooms, and message boards have opened up for patients and providers alike, the technology known as health 2.0 or medicine 2.0 is not without risk.

“This opens up a multitude of opportunities for patients,” Kevin Clauson, associate professor of pharmacy practice and a specialist in drug information at Nova Southeastern University (Palm Beach Gardens, Fla.), said here Friday at the first Medicine 2.0 Congress, which attracted 180 people from 19 countries for an academic-level discussion on interactive health-IT. He noted that PatientsLikeMe has become a popular forum and virtual support group for those with serious health issues.

Health 2.0 also can open up organizations to embarrassment or possibly even legal liability when it comes to interaction between patients and practitioners. Clauson noted that pharmacists in the U.S. have a “duty to warn” if patients are put in potentially unsafe situations. But it is not clear, Clauson said, if this duty extends to patient-posted content that may indicate that person is taking drugs that may interact with each other.

As more providers move to electronic health records and personal health records that patients can view, the public might be surprised to learn that clinicians have their own form of derogatory slang. Clauson said some popular descriptions he has seen in medical charts include: “CLL” (“chronic low-life”), “LOBNH” (“lights on but nobody home”), and “grave dodger” to describe a chronically ill elderly patient. What happens if patients suddenly start reading such language?

Messages often do get muddled online. E-mails and blogs are wide open to misinterpretation, since it is difficult to communicate tone in typed text. “Poor communication is exacerbated by writing because most people don’t write very well,” Clauson added.

Sometimes, organizations may get hurt by poor judgment that is completely beyond their institutional control. Clauson highlighted a study published in the July issue of the Journal of General Internal Medicine that found that medical students at the University of Florida were less than discrete with some of their Facebook pages. Some belonged to groups called “Physicians Looking for Trophy Wives in Training” or “PIMP: Party of Important Male Physicians.” Others were pictured grabbing the breasts of classmates, visibly drunk, or wearing a lab coat that said “Kevorkian Medical Clinic.”

Clauson recommends that organizations educate their staff about some of the hazards associated with health 2.0 before minor gaffes become major problems. “It is possible to some extent to ameliorate these risks with good judgment and risk management,” he said.



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