I just saw an article on the Running A Hospital blog that reminds me of a constant battle I keep fighting.

I have talked with numerous health care CIO and CMIO types across the planet (mostly via social media) about their organizations constant wish to block the horribly evil Facebook, Twitter, LinkedIn, MySpace, etc.   They always site the same things.  Basically their reasoning boils down to individual staff productivity, intellectual property rights, and confidentiality.  These points come across much stronger from the health care field as the field has massive regulation around the areas of privacy and confidentiality.  This regulation often breeds a significant amount of fear of social media (and sometimes the internet in general).

After hearing these same arguments over and over I have to just stop and say “really? seriously folks?”.  Do leaders really believe that none of our problems around productivity, retaining organizational secrets, and  keeping the confidence of our patients existed before the Internet came around?  I know they don’t.

As leaders, we are aware that if we fail to properly manage staff, they will be less productive.  In the most simple description for a non-motivated employee:

if you take away Facebook, they will go to MySpace;
if you take away the Internet, they will play solitaire;
if you take away the computer, they will bring a magazine;
if you take away the magazine, they will nap.

I really look at this as a process problem.  (Remember?? Process first!)  Let us look at the root cause of the issue.  The root cause is that the employee is not motivated to accomplish their job.  Social Media is just an escape route for keeping their mind busy. This isn’t something that can be fixed by taking away the Internet.  It needs to be handled by a diligent and concerted effort to engage the employee.  This may be in a change of tasks, a change in direction, or may result simply in that the staff member is not a good fit for the organization.

What about intellectual property and confidentiality?  “OH MY… they could share pictures of a patient or a discovery on Facebook!”….  Again, I go right back to the root cause.  If you block the Internet at work, and the employee is sufficiently excited about sharing something they have from work, they will simply go home and put it online (or just use their smart phone, which you probably can’t block).  In the ages and millennium before the age of the Internet people would take pictures and pass them around on paper (yes, archaic, but it did happen).  Also in the ‘olden days people would sit at the local ballpark with hundreds of folks around and gossip openly about “something they saw”.  The point is, that yet again, the employee is the problem, not the medium the employee uses to convey their message.

Most organizational leaders are very intelligent.  They realize that the employee is the root cause of the issue.  So why are so many leaders intent on crushing social media while they were just fine with paper or papyrus  before? It all boils down to the very reason so many people love social media to begin with – its viral nature.

The viral nature of social media causes many organizational leaders to shudder.  The ability to share information across the world with thousands+ of people in a very short time creates issues of liability and limits the organization’s ability to “put the lid on the issue”.  Damage control can be nearly impossible.  Simply think about all of the ruckus caused by the completely false email about “Kentucky Fried Chicken” changing their name to “KFC” because “they were growing mutant, genetically spliced chicken-like creatures” instead of real chicken.  A post like that coming from your internal company employees could be massively damaging.  In the health care world, if an employee were to make something up, or worse yet, post something that was actually true, you would be looking at huge damage to your hospital or clinic business and possibly large HIPAA and HITECH fines.  The inability to perform damage control, and the possible liabilities from unmanageable communications provide a strong case to many health care leaders as why they should not allow social media at their sites.  I agree these are stirring concerns, but I don’t agree with the remedy of blocking internet sites at work.

The main problem with the “just block it” solution comes down to the fact it is nearly impossible to do.  Certainly, IT shops can block specific sites at router levels or even turn off the Internet entirely, however, thanks to Droid, Apple, Palm, home internet, and countless free internet hot spots, practically anyone that would use a social media site can do it from a location that is not under the medical facility’s control.  So how do you deal with such issues? We can’t simply throw up our hands, and frankly I would not support anyone simply accepting the risk.

Policy, education, and then some more policy and education.  Sadly there is no silver bullet for the issues that social media brings to a health care organization.  You can’t simply shut off the sites and controlling people’s speech outside of your organization is not legal (nor should it be).  The best option is to leverage the policies you already have for confidentiality (EVERY health care person reading this has these policies) and expand them to include social media.  If an employee breaks confidentiality and releases patient health information online, treat it exactly as if they had broken the rule while at the ballpark.  The rules for confidentiality, privacy, and intellectual protections should all be universal and equal to any situation, whether physical or virtual.  As for productivity, do the same thing.  If one of your staff isn’t doing their job, then you need to deal with the issue.  The reason for them not completing their job shouldn’t matter.  I would treat any staff member the same if they were under performing for any reason.  First communicate the expectations, second measure that expectations are being met.  If expectations are not being met, find out why and decide what needs to be done, etc.  Your policy and approach should be the same whether the person is on Facebook too much or talking on the phone too much should not matter, it is the same issue.

As for education your staff will need to be told that the Internet is public and that all of the normal rules apply (especially confidentiality).  They need to remember and be reminded that anonymity is not as common online as people believe.  Many people simply don’t think about the Internet as being public.  They think that they are in a room with their “friends” and rarely contemplate that they are among the public.

If you want an example of a site doing it right, look to Mayo Clinic.  I say that not only because of my connection to them, but because they have taken the time and effort to be leaders in the health care field on social media.  Mayo allows social media to be used by employees, but they provide education, guidelines, and overall policies that help guide the staff to the proper use of any social media platform.  Along with guidance, they actually encourage the responsible use of social media.

What does this all break down too? Social Media has huge values, don’t get stuck in the trap of liability and performance arguments.  Empower your staff through policy and educational guidance.  And as I liked to say a decade ago in my former life:

“SILLY MANAGER…. Internet abuse is a MANAGEMENT issue”