A newsletter on the current legal issues facing today’s care industry July 2009 , Meet Health Care: The Potential Benefits of Online Social Networking in the Health Care Marketplace

By Elizabeth G. Litten

Using technology to improve be modified, secured and assimilated with information-sharing, but there are also clear patient care and the HIE network model? Can the software differences between social networking and communication related to technology that makes social networking so health information networking, aren’t there? patient care is not an entirely fluid and seemingly straightforward be new concept; however, it has adapted for use in the health care context? Sharing in Real Time recently picked up significant It’s a concept that deserves a closer look. Most patients would not want Facebook, momentum. More and more LinkedIn or any other proprietary social health information exchange (HIE) networks The Age of the iPhone networking web site to have the ability to are popping up at the community and state- As the health care IT community wrestles access their personal health information. wide levels. Nowadays, a health with connectivity challenges, privacy barriers Nor would most patients want these care provider may participate in a regional and other issues, the up-and-coming companies to see their personal, online health information organization (RHIO), and generation networks electronically without a network of “friends” (in the health care Internet-based (PHR) second thought and as simply and easily as context case, physicians, or other health repositories, such as ’s HealthVault Generation X used to call childhood friends care providers and payers) and and Google’s GoogleHealth, have become on the phone. More simply and easily, in communications grids, not to mention the familiar household names. Soon, it is fact, since they can essentially “call” advertisements. But there are some expected and hoped that health information multiple friends and groups of friends perquisites to sharing personal information will be exchanged across the nation in an simultaneously and without the usual in real time and in a flexible, individualized organized, coordinated and easily-accessible impediments of chronological time. Users format. manner. But even this trend is not catching can post an “away” message to act as a For example, if a patient wanted to share a on at the same speed as social networking more specific type of “busy” signal but can surgeon’s report from his 2002 knee surgery sites. also jump in and out of conversations at any with his sports medicine physician in 2009 The sharing of health care information, time and pause or speed up the and wanted to allow side-by-side access to whether through a RHIO or other HIE communications. They can hold one both his 2002 and 2009 MRIs, then real- networks, is often thought of as the linear conversation or many, connect into other time sharing through social networking sending or receipt of information related to conversations, personal web pages or pools technology could be as easy as posting medical care that has been or will be of communication, and they generally view recent vacation photos for friends and family rendered to a patient. For example, we the fluid, spherical nature of these online. If the patient controls the input and would send an electronic health record to communications as more natural than (and flow of his own information, perhaps the another provider or request a test result to perhaps preferable to) the structured, linear need for 400 or more pages of contract be sent from the diagnostic facility to the nature of communication via a standard provisions dissipates. Or, if a patient wanted primary doctor for follow-up or send a claim landline telephone. to share information with a specific group of to the payer for reimbursement. With the recent prevalence of social female friends about a terrific ob/gyn, social Now imagine if such information could be networking sites such as Facebook and networking technology would make it easy shared in present “real time” directions. And LinkedIn, information can be shared widely, for those friends to connect with the ob/gyn what if that could be achieved with less selectively, in overlapping concentric circles, (perhaps by simply as adding the ob/gyn as administrative burden and lower costs than in broad orbits and in nearly as many ways a “friend” to the group). This would be a is needed for other HIE network models? as there are people accessing the sites. way to open the door and invite interested Enter the “Facebook” social Internet network Clearly, these social networkers don’t need a people into the store, rather than keeping model, and the question of what if it could 400-plus page document to guide their them outside at the Internet-equivalent of

California Connecticut Delaware Florida Nevada New Jersey New York Pennsylvania www.foxrothschild.com window-shopping. While the patient’s female asthma or heart disease, the Medicaid HMO Facebook user’s page resides on the friends may not see the fabulousness of the that has access to the past several months Facebook web site) but can be accessed ob/gyn simply by peering at the physician’s or years of claims information can more and shared via software applications tailored web site from the outside in, they can more quickly and efficiently determine or address to the users’ needs, the bulk, weight and quickly decide whether the ob/gyn is a the patient’s needs. The Medicaid HMO associated friction of moving information potential match for their needs when they does not need information related to the from one place to another nearly evaporates. are greeted at the web site or personal dollar amounts of these claims, but having The painstakingly created pathway would no profile of the ob/gyn by an open door, and ready access to the codes associated with longer be needed, since the Internet allows are invited to walk in and begin the claims will give the HMO a valuable movement in any direction and in real time. communicating with the physician directly. snapshot of the patient’s health history and A medical record can be accessed current or future health care needs. electronically, but it does not necessarily Moving Forward While Protecting Privacy If all of this communication takes place need to be transmitted from point A to point Adapting the power of social networking to under the umbrella of the Medicaid HMO B along a specific pathway. the health care information world requires (whether on its own server or on secure The ability to adapt social networking into an understanding of how the information will space on an outside server), the Medicaid health information sharing will evolve as be shared and how and when it must be HMO can ensure the privacy and security of software develops and as the use and protected. For example, a managed care personal health information, just as it does refinement of electronic networking tools organization that contracts with New Jersey with members’ personal health information increases. In the meantime, standards Medicaid (a Medicaid HMO) may recognize now, and can develop tools specific to the panels, along with many others interested in the need to access claims information from needs of the members and providers. virtual health information networking, will a new member’s previous Medicaid HMO. keep their linear focus on the legal and Unlike individuals enrolled in commercial Similarly, a hospital or physician group that imports the social networking tools for use in operational barriers of health information HMOs or health insurance plans, Medicaid sharing, one connection at a time. HMO members can move from one HMO to health information sharing can set the another on a frequent basis, so the new parameters and protections necessary for For more information about this topic, Medicaid HMO may have very little medical efficient, effective communication. Lines and contact Elizabeth G. Litten at 609.895.3320 information about the member. If the new spheres of communication can be opened or [email protected]. Medicaid HMO member requires a and closed, as appropriate. Because the This article first appeared in Advance for diagnostic test or help in managing a information being communicated resides in Health Information Executives and is chronic health care condition such as one place (similar to the manner in which a reprinted here with permission.

Attorney Advertisement © 2009 Fox Rothschild LLP. All rights reserved. This publication is intended for general information purposes only. It does not constitute legal advice. The reader should consult with knowledgeable legal counsel to determine how applicable laws apply to specific facts and situations. This publication is based on the most current information at the time it was written. Since it is possible that the laws or other circumstances may have changed since publication, please call us to discuss any action you may be considering as a result of reading this publication.

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