After my dismay at how a breach seemed to be casually revealed on Twitter last weekend, I thought I’d keep an eye out for situations in which use of social media might raise the specter of the HIPAA privacy rule. In the example below, I do not think that the twitterer violated the rule in any particular tweet nor in the aggregate, but when we start to aggregate information, it becomes increasingly possible that someone might recognize themselves or a family member. Indeed, I wouldn’t be surprised if others looked at the same situation and argued that there has been a HIPAA violation. See what you think:
In response to the above tweets, another twitterer replied, “Nd u just violated #hipaa.”
The original twitterer responded, “you clearly don’t know HIPPA then, I never mentioned any names.”
Ignoring, for the moment, my wholly untested hypothesis that people who spell the HIPAA acronym correctly are more likely to comply with it, who’s right?
We all know that it’s possible to identify a patient without using their name, but the twitterer may well be correct that she didn’t violate HIPAA by her tweets. So far, all that’s been revealed is the date of the tweet, that it was an emergency room, and the time period during which the patients were seen in the ER.
But does the fact that the twitterer provides a picture of herself in her profile increase the risk of knowing who the patients are or of the patients recognizing themselves in her tweet?
And does it matter that she gives latitude and longitude/GPS coordinates in her profile?
I haven’t checked, but suppose it turned out to be a small community with only one hospital in the area. Would that make a difference in both the risk of identifying patients or patients recognizing themselves as being one of the people she tweeted about?
We can probably all share the twitterer’s desire to discuss something that was unusual at work. There are times we may want to vent, or we may have a really unusual case that we’re tempted to share. Resisting the siren’s call to tweet or share in a world where the repeated message is “share more” can become increasingly difficult. But contrast her tweets to that of another twitterer who tweeted earlier the same day:
Two different twitterers. Both with something they wanted to talk about, but two different decisions as to whether to say anything in a public space or not.
Given the risks inherent in posting anything in social media that refers to patients, I think the second twitterer has chosen the more prudent path.