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Social Media Series: Article Two – Policies and Procedures

by Kristen Stuppy, MD, FAAP

There are many benefits to having a social media presence, but many have resisted due to legal risks, time constraints, and uncertainties. While it is true that health care companies have run into problems with patients being identified—a clear HIPPA violation, these risks can be minimized to allow a medical office to have a strong and respected online presence. Before making your social sites public, be sure to draft a policy that is available for all users.

All businesses should have a Social Media Policy, regardless if your business has a social media presence or not. Your employees are likely on Facebook, Twitter, LinkedIn, or another site. A policy should address if they can access on-line sites during business hours from their phone if they have a down moment. It must address how office computers are used and if the office computers are monitored or if access to restricted sites is blocked. Discuss with employees the potential risks of becoming Facebook friends with co-workers and patients (note: this is VERY difficult to monitor). They need to be informed formally within the policy and reminded verbally at meetings to never associate any work related information on line, even if they don’t mention patient names. This may seem obvious, but many people post about things that happen to them. The more people post, the more acceptable postings seem, when in reality posting about someone else is never acceptable. Working in any busy office is full of emotional events, and emotional events are often posted. Inform staff how office computers will be monitored and if any sites will be restricted.

Identify who in your office will be responsible for blogging or posting to Facebook or Twitter for your practice. They should be properly identified by name on the page, but the page name should be reflective of the office if you are using it for marketing purposes. This not only gives ownership to what they author, but it allows patients (and potential patients) to identify with the author. If you hire an outside blogger, be sure to identify who they are and their credentials. Those who have administrative responsibilities to your social media must understand the issues of patient confidentiality, the use of generalizations, and the need to include a broad range of patients and potential patients without alienating any particular group of people. They should be allowed to voice their opinions, but they should choose their subject matter carefully and be very cautious if the subject is debated. It the subject matter is questionable, they should make a clear disclaimer that they are reflecting personal thoughts, not necessarily the position of the practice. Identify who is responsible for reviewing responses from followers and how often should they look at your sites to be sure posts and comments are appropriate.

If you want to see examples of company Social Media Policies, a great resource is Social Media Governance.

Before making social media sites public, make a policy for users of your sites – the public. Address common issues in your policy, such as privacy/public view, solicitation, demeaning or foul language, inappropriate photographs, etc. Post the policy initially and re-post it from time to time. The frequency of re-posting your policy varies by how your site is used by your followers. If used properly, there is no need to keep preaching to the choir. If people use it inappropriately, remind all what is expected, such as no soliciting medical advice on the public forum. Give them alternate means to ask individual advice, such as an office visit, phone call, or encrypted (secure) email. As an example, we have our user’s policy on our Info Facebook page, blog, and on our website.

Feedback from your followers can greatly benefit when positive comments about your practice or an employee are posted, but you need to closely monitor your media. Many blogs have settings that any posts must be reviewed prior to being seen on line. This can allow easy containment of negative comments. Other public sites, such as Facebook or Twitter, do not have this capability. If your settings allow postings, you must screen all comments regularly, at a minimum of once a day.

Any negative comments posted will need to be addressed on an individual basis. The way negative comments are handled can actually reflect very well on your office, if done correctly. Many can be used as an educational opportunity for your office or the poster and show followers that you are addressing issues. For example, if the poster complains about wait times in your office, you can come across as a good listener and willing to work on the issue, not just one who buries problems under the rug. Not only does deleting a post after some viewers already saw it make the practice seem less open for suggestions, it can upset the poster even more, leading to more negative posts, often on their personal pages which you cannot control. First reassure the poster that their time matters, acknowledge their inconvenience, and assure them that when it is their turn as much time as needed will be spent with them. Then you can add information about why people wait in future posts, not directed at the post specifically, but as information for your followers. This information allows all your followers to see your point of view or from another blogger. Talk about wait times with your staff to see what can be done to improve flow, and what staff can do if you are behind.

Posts that threaten anyone’s privacy or are inappropriate should be removed immediately. A personal message or phone call (if a number is known) to the poster can be made if appropriate to discuss why you are removing it. Repeat or serious offenders can be blocked from posting again to your page, but you do not have control what they post elsewhere.

I wish I remember where I heard this, because I would love to give credit where credit is due, but I don’t remember. I am ending with it though because it is so appropriate to share with your staff. I call it the “Front Door Policy”:

Post only what you would want on your front door for all to see. If it isn’t appropriate for your neighbors and your mother to see, it isn’t appropriate online.

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