These guidelines apply to all medical trainees registered at the Faculty of Medicine at the University of Ottawa, including undergraduate students, graduate students, postgraduate students, postdoctoral fellows, clinical fellows, clinical research fellows, or equivalent. Use of the Internet includes posting on blogs, instant messaging (IM), social networking sites, e-mail, posting to public media sites, mailing lists and video-sites.
The capacity to record, store and transmit information in electronic format brings new responsibilities to those working in healthcare with respect to privacy of patient information and ensuring public trust in our hospitals, institutions and practices. Significant educational benefits can be derived from this technology but trainees need to be aware that there are also potential problems and liabilities associated with its use. Material that identifies patients, institutions or colleagues and is intentionally or unintentionally placed in the public domain may constitute a breach of standards of professionalism and confidentiality that damages the profession and our institutions. Guidance for medical trainees and the profession in the appropriate use of the Internet and electronic publication is necessary to avoid problems while maintaining freedom of expression.
Postgraduate trainees are reminded that they must meet multiple obligations in their capacity as university students, as members of the profession and College of Physicians and Surgeons of Ontario (CPSO), and as employees of hospitals and other institutions. These obligations extend to the use of the Internet at any time – whether in a private or public forum.
Undergraduate medical students are reminded that they must meet multiple obligations in their capacity as university students and as future members of the profession. These obligations extend to the use of the Internet at any time – whether in a private or public forum. These guidelines were developed by reference to existing standards and policies as set out in the Regulated Health Professions Act, the Medicine Act and Regulations, CPSO The Practice Guide: Medical Professionalism and College Policies, September 2007, Faculty of Medicine Standards of Ethical and Professional Behaviour, and the Core Values of professionalism, University of Ottawa.
Medical trainees are also subject to the Personal Health Information and Privacy Act as “health information custodians” of “personal health information” about individuals.
General guidelines for safe Internet use:
These guidelines are based on several foundational principles as follows:
- Patient privacy and confidentiality must be maintained at all times;
- An obligation exists to maintain the privacy and security of patient records under The Personal Health Information Protection Act (PHIPA), which defines a record as: “information in any form or any medium, whether in written, printed, photographic or electronic form or otherwise;”
- The content and tone of all electronic communications must remain respectful and professional;
- Material published on the Web should be considered permanent and public;
- Bloggers are personally responsible for the content of their blogs.
Posting information about patients
- Never post personal health information about an individual patient.
- Personal health information has been defined in the PHIPA as any information about an individual in oral or recorded form, where the information “identifies an individual or for which it is reasonably foreseeable in the circumstances that it could be utilized, either alone or with other information, to identify an individual”.
- These guidelines apply even if the individual patient is the only person who may be able to identify him or herself on the basis of the posted description. Trainees should ensure that anonymized descriptions do not contain information that will enable any person, including people who have access to other sources of information about a patient, to identify the individuals described.
Exceptions that would be considered appropriate use of the Internet
It is appropriate to post:
- with the express consent of the patient or substitute decision-maker;
- within secure internal hospital networks if expressly approved by the hospital or institution. Please refer to the specific internal policies of your hospital or institution;
- within specific secure course-based environments that have been set up by the University of Ottawa and that are password-protected or have otherwise been made secure (even within these course-based environments, participants should “anonymize” individuals);
- when no patient identifiers are associated with materials presented; and
- when factual rather than judgmental language is used to describe patient behaviour. All events involving a patient should be described as objectively as possible, e.g., describe a hostile person by simply stating the facts, such as what they said or did and surrounding circumstances or response of staff, without using derogatory or judgmental language.
- entirely fictionalized accounts that are so labeled.
Posting information about colleagues and co-workers
- Respect for the privacy rights of colleagues and co-workers is important in an inter-professional working environment.
- If you are in doubt about whether it is appropriate to post any information about colleagues and co-workers, ask for their explicit permission – preferably in writing.
- Making demeaning or insulting comments about colleagues and co-workers to third parties is unprofessional behaviour.
Professional communication with colleagues and co-workers
- Respect for colleagues and co-workers is important in an inter-professional working environment.
- Addressing colleagues and co-workers in a manner that is insulting, abusive or demeaning is unprofessional behaviour.
Posting information concerning hospitals or other institutions
- Comply with the current hospital or institutional policies with respect to the conditions of use of technology and of any proprietary information such as logos or mastheads.
- Medical trainees must not represent or imply that they are expressing the opinion of the organization.
- Be aware of the need for a hospital, other institution and the University to maintain the public trust.
- Consult with the appropriate resources such as the Public Relations Department of the hospital, Postgraduate or Undergraduate Medical Education Office, or institution who can provide advice in reference to material posted on the Web that might identify the institution.
Penalties for inappropriate use of the Internet
The penalties for inappropriate use of the Internet include:
- Remediation, dismissal or failure to promote by the Faculty of Medicine, University of Ottawa.
- Prosecution or a lawsuit for damages for a contravention of the PHIPA.
- A finding of professional misconduct by the College of Physicians and Surgeons of Ontario (residents only).
Enforcement
All professionals have a collective professional duty to assure appropriate behaviour, particularly in matters of privacy and confidentiality.
A person who has reason to believe that another person has contravened these guidelines should approach his/her immediate Supervisor/Program Director for advice. If the issue is inadequately addressed, he/she may complain in writing to the appropriate Vice-Dean, Medical Education or to the College of Physicians and Surgeons of Ontario through designated processes.
Complaints about breaches of privacy may be filed with the Information and Privacy Commissioner/Ontario.
Senate Reference 09:M05:33 Approved: November 30, 2009