The double-edged sword of social media

What healthcare providers and organizations need to know

Wednesday, November 8, 2017 – Michelle Holden

“If it’s going on the internet, assume the person sitting next to you on the bus is going to be able to read it,” said Meghan Payne, Senior Associate, Borden Ladner Gervais LLP during a recent HIROC webinar. This is a good litmus test for your message, says Payne, who emphasized that nothing on the internet is ever truly private.

The October webinar, Social Media in Healthcare – co-presented by Payne and Anita M. Varjacic, Partner at Rogers Partners LLP – delved into the legal perspectives of social media in healthcare and strategies on how to respond to posts that could potentially impact reputation.

In Ontario there is no specific legislative guideline with respect to the use of social media but the Regulated Health Professions Act and the Personal Health Information Protection Act both offer principles and laws that can be applied.

The two lawyers shared practical tips to consider before posting from one’s personal or corporate account:
  • Identify the intention behind the post
  • Determine if there are other (better) ways to communicate the message
  • Identify who may be impacted by the post
  • Assess whether the post may blur boundaries between personal relationships and professional-client relationships
  • Consider whether the post could affect the public’s trust in the health profession, the healthcare organization or the industry

Case by case

During the session, Varjacic shared a case about a nurse working in a long-term care facility. The nurse took it upon herself to blog about the experience of a family member who was a patient at the facility. In the blog the nurse criticized the treatment the patient had been receiving while also sharing that she worked as a nurse. When the blog came to the attention of the facility, the nurse decided to take her case to her professional body.

The nurse’s provincial regulatory authority (college) determined that she had been using her professional status to influence and that she should have expressed her grievances to the facility rather than publically online. She received a $1,000 fine and was also ordered to pay $25,000 of her college’s legal fees.

“Having a policy or protocol with respect to social media is an important takeaway and is something that all organizations should look at no matter how big or how small,” said Payne.

Document, document, document

Another key theme that surfaced is the importance of documentation, even in the social space. Providers may be connecting with clients via text message or a social media page and believe that the information is saved in that platform if it needs to be referenced later. “One of the challenges here is the platforms always change,” said Payne, explaining that social media accounts frequently change their algorithms and those conversations may be gone when you need them.

She emphasized that the best way to avoid this is by documenting in the official patient record. “If it’s related to someone’s healthcare and their treatment, it needs to be a part of their medical record,” added Varjacic.

Payne also said that no matter how you’re communicating, it’s important to ensure a professional boundary between provider and patient. “The obligation is on the healthcare provider to maintain that relationship and maintain those boundaries,” said Payne, referencing College of Nurses of Ontario’s standards.

While the session focused on a theme of caution when it comes to the use of social media in healthcare, the reality is such that even those organizations that are not online are still being talked about online. Having that presence, Payne stressed, can at least give you some degree of control over how you’re represented. “Creating an online presence can be to an organization’s advantage,” she said.

Participants in the webinar came away with the resounding message that with so many Canadians engaged in the social sphere, it’s a great way to communicate and share information…as long as everyone thinks carefully before posting and is aware of the risks.  

Key resources for healthcare organizations and providers

Throughout the session, Payne and Varjacic highlighted the following guidance documents and educational materials that can be applied to social media (Ontario-based):
  • Regulated Health Professions Act
  • Personal Health Information Protection Act
  • College of Midwives of Ontario: “Midwives Using Social Media”
  • Association of Ontario Midwives: “Like, Follow, Share: Midwives Online”
  • College of Physicians and Surgeons of Ontario: “Social Media – Appropriate Use by Physician”
  • College of Nurses of Ontario, professional standards:
    • “Professional Standards”
    • “Therapeutic Nurse-Client Relationship”
    • "Confidentiality and Privacy: Personal Health Information”
    • “Ethics”
If you were unable to watch the live event, a video recording of the webinar is available. For more information, review HIROC’s Risk Note on social media.

Michelle Holden is Communications and Marketing Specialist, HIROC

Meghan Payne is a senior associate in the Toronto office of Borden Ladner Gervais, practicing with the Health Law Group.  She specializes in medical malpractice defence and occupier’s liability claims, and has a robust mental health law practice.  Meghan can be reached at or (416)-367-6631.

Anita Varjacic is a partner with Rogers Partners LLP, a boutique defence firm in Toronto. She practices in many areas of insurance law, with a particular emphasis on medical negligence claims. She has been working closely with HIROC and the Association of Ontario Midwives for over 15 years. Anita can be reached at or 416-594-4522.