Public Tweets, Private Matters
I'm wrapping up an extensive print and online package about social media for our September issue (Look for it next week!), and with all the reading, interviewing and, yes, tweeting I did to research the phenomenon, I thought I'd heard everything.
Well, this morning I came across this blog, which references another blog (isn't linking great?) about a sticky situation involving HIPAA and Twitter. Sure, nurses and other hospital staff have begun tweeting from the operating room, but what about a patient who tweets her own trauma--and makes accusations in the process?
According to the blog, after suffering a "serious spinal fracture," tech consultant and blogger Sarah Cortes sent tweets from the Pennsylvania hospital that was treating her, seeking a second opinion from doctors back home in Boston.
Tweeting about her condition was fine and dandy, but Cortes now claims the posts saved her from unnecessary surgery. According to her account, the hospital pressured her to get reconstructive spinal surgery, an expensive procedure that could improve the hospital's accreditation status. After tweeting and talking via cell phone with a doctor from Beth Israel Deaconess Medical Center (BIDMC) in Boston, Cortes declined surgery and sought care at BIDMC, which used a non-surgical approach to treat her back.
Cortes has since deleted the tweets she sent during her medical escapade--she even admitted they were "urgent-sounding"--but she sticks to her guns that the Pennsylvania hospital had ulterior motives. But here's the real kicker--the hospital can't respond. HIPAA bars doctors, nurses and hospital spokespeople from discussing Cortes' case, like the severity of her injury or what treatment was advised. The hospital denies that it pushed unnecessary surgery for financial gain, but it can't offer much more defense than blanket statements about honesty, integrity and patient care being No. 1.
The case has the stuff of courtroom dramas--accusations, greed, deception--and it's all being broadcast across the blogosphere. But the story also touches upon many of the same health care issues lawmakers are trying to solve. According to Cortes, the Pennsylvania hospital opted for excessive care, which experts say is a leading cause of rising health care costs. On the other hand, Cortes commended the BIDMC doctor for being accessible and responsive even late at night--traits that could become more common as health reform calls for greater quality and better coordination of care. And, as hospitals are learning, they'll have more than just privacy concerns to worry about as patients become more active decision-makers regarding their own care.
What do you think about this case? Cortes felt free to publicize her treatment, so should the hospital be released from HIPAA constraints? Is the Internet an appropriate place to discuss treatment or criticize a facility's approach?