How to Maintain Patient Confidentiality on Social Media

• It’s tempting to share information about your nursing career on social media, but in doing so, be sure to maintain patient confidentiality. 
• Any misstep, whether intentional or not, could lead to legal implications and decrease trust in the nursing profession. 
• Following the National Council of State Boards of Nursing’s guidelins for social media as a best practice. 

Social media poses numerous challenges to healthcare professionals who want to use it effectively as part of their profession. One is striking an equilibrium between engaging online communities and adhering to patient privacy regulations. 

The Health Insurance Portability and Accountability Act (HIPAA) is an essential piece of healthcare legislation with widespread implications across social media. 

Nurses are familiar with how HIPAA relates to patients in their work facility, but they might not be aware of its implications in their private social media postings. HIPAA protects patient confidentiality by safeguarding protected health information (PHI). PHI is any identifiable data relating to physical or mental healthcare conditions or services and payments received. Nurses must always be mindful not to inadvertently disclose PHI on social media. 

To be compliant with HIPAA, never disclose any patient’s identifiable information, including but not limited to: 

• Names.
• Dates of birth.
• Social Security numbers.
• Medical record numbers.
• Photographs or videos of patients without written consent.

Even seemingly harmless details can potentially lead to the identification of a patient, so: 

• Do not associate the patient’s medical conditions or treatment with the name of the facility where you work. 
• When discussing patient care experiences, use general descriptions that do not reveal the patient’s identity. 
• Ensure that your social media accounts have strict privacy settings.
• Only connect with trusted individuals and avoid accepting patients or family friend requests.  

Breaching Patient Confidentiality

If patient confidentiality is breached online, it could result in legal penalties, regulatory action by various bodies, and damage to your professional reputation. HIPAA violations can also break the trust between patients and healthcare systems. Staying within HIPAA regulations on social media is both a legal obligation and integral to providing safe, ethical care that prioritizes patient safety.

HIPAA violations on social media often stem from accidental sharing or breaching of PHI, or by breaching patient confidentiality. An example would be if a nurse posts images or status updates about challenging patient cases without sufficiently de-identifying information, ultimately disclosing sensitive details about a medical condition, treatment plan, or individual’s identity. 

Shared stories that inadvertently reveal patient data can also violate HIPAA regulations, even without express mention. Social media comments or interactions in which patients are discussed, identified, or diagnosed — even with good intentions — may violate patient privacy and confidentiality because these discussions occur on public platforms where data protection cannot be assured. A pediatric nurse, for example, who posts about the death of a newborn and how difficult the situation was might have good intentions of expressing empathy for the family, educating the public, or even just processing the experience. But a high-profile case found in the news can be pieced together from a post like that and be a HIPAA violation.

Healthcare professionals must exercise extra caution when responding to patient inquiries or discussing healthcare-related subjects on social media. Providing medical advice about individual patient circumstances may violate HIPAA regulations and pose risks to patient safety. Sharing photographs or videos obtained with patients’ permission could violate HIPAA regulations if proper authorization forms and protocols aren’t followed. 

10 Guidelines for Nurses Using Social Media

The National Council of State Boards of Nursing has proposed the following guidelines for nurses using social media:

1. Protect Patient Confidentiality

Whenever posting to social media, always protect patient confidentiality by adhering to privacy standards and not discussing individual patient cases, sharing identifiable data without their prior approval, or posting photos/videos without their explicit approval.

2. Stop and Think Before Posting

Before sharing anything on social media, consider its potential ramifications — once something has been published online, it may be hard or even impossible to remove or retract it later. 

3. Maintain Professionalism

Conduct yourself ethically and respectfully on social media, reflecting the standards and values of nursing as a profession. Avoid engaging in heated debates, using offensive language, or sharing posts that could be seen as unprofessional. 

4. Recognize Boundaries

Always remember professional boundaries when engaging with patients, colleagues, and employers on social media. Avoid adding patients as followers on personal accounts and discussing work-related matters in open forums. 

5. Assess Information

Before posting information online, verify its accuracy and reliability by checking sources. Also, cite credible resources when sharing healthcare-related material online. 

6. Be Transparent

When engaging in discussions or posting content related to healthcare on social media, disclose your professional affiliation and role as a nurse. This helps build trust with your target audience.

7. Monitor Privacy Settings

Review and adjust the privacy settings on all social media accounts regularly to restrict who can see your posts and your personal details so that only your target audience has access.

8. Be Mindful of Tone

When posting social media updates, be conscious of your words and tone. Consider what impact these could have on the audience you’re reaching. Maintain a respectful, positive tone in all interactions, even in times of disagreement or criticism. 

9. Engage Responsibly

Leverage social media to foster constructive dialogue, collaboration, and professional growth.

10. Communicate Effectively

Communicate with peers who may share valuable resources that enhance patient care while contributing to meaningful conversations that advance nursing as an industry and improve care delivery.

The Bottom Line

It’s possible for healthcare professionals, including nurses, to inadvertently violate HIPAA or breach patient confidentiality when posting about their work life on social media. Exercise extreme caution and be sure to eliminate any identifiable information when discussing patient care or experiences online. Follow NCSBN’s social media guidelines as a best practice. 

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