I have been asked several times why I blog and how I find the time to do it. Like some of my colleagues (virtual and real), I blog because it’s cathartic for me and in some small way, I’d like to believe I am promoting a more honest discussion among peers by participating in a forum that allows input from patients, caregivers, and providers. I know my experiences in medicine are not singular, and it has been heartening to get feedback through the blogosphere, Twitter, and LinkedIn (among others) that others have shared similar experiences.

For me, there is a process of blogging—creating content, editing stylistically, and trying to make my points as succinctly as possible. However, when it comes to sharing clinical experiences, one thing is even more vital—feedback. At ASCO, I rely on feedback from one person in particular, Amy Fries, the managing editor of ASCO Connection, the member magazine, and ASCOconnection.org, its companion social networking site. For me, she has become my sounding board, proofreader, and (more importantly) another set of eyes to help me determine if I am in compliance with the Privacy Rule. In short, the Privacy Rule regulates how to use (and disclose) specific and individually identifiable health information (i.e., protected health information or PHI). The definition of what constitutes PHI is fairly broad: “If the information identifies or provides a reasonable basis to believe it can be used to identify an individual, it is considered individually identifiable health information.”¹

The importance of patient confidentiality in blogs is not to be taken lightly. As my colleagues and I wrote in an article published in the Journal of Oncology Practice, cases of physicians blogging about patient visits have led to prosecution and loss of medical licensure when appropriate steps to protect patients from being identified in specific posts were not taken.

In that vein, I have become accustomed to Amy’s first read of a blog while it is in its infancy. She can help identify areas of potential problems and works with me to address them. While such formalities are not required (I certainly am not the voice of ASCO and Amy’s review does not reflect any endorsement or assurance that I am in compliance; that is solely my responsibility), I have found the process incredibly helpful—collaboration at its best.

For those who are involved in social media outlets (i.e., Twitter and Facebook) or who blog on their own, I have learned to be conscious of the importance of deidentification—whether it is changing aspects of a clinical experience to preserve anonymity or the avoidance of mentioning personal information (i.e., names and ages). It is essential that our writing (blogging, tweeting) conforms to the Privacy Rule. Although I may feel at first glance my work has been sufficiently anonymized, having a second set of eyes review it with an eye towards the Privacy Rule has proven to be an important asset for me.

I would encourage all of us to utilize your own “Amy Fries” as we engage in these emerging social media outlets.

Reference

1. HIPAA Privacy Rule and Public Health: Guidance from CDC and the US Department of Health and Human Services. MMWR 2003; 52:1-12. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/m2e411a1.htm. Accessed 1/9/2013.