Hospitals Can Block Facebook But Not the 21st Century


Healthcare organizations – hospitals in particular – have a moral and fiduciary duty to understand, evaluate and intelligently adapt to the technological and communications conditions of today.

This is a public health matter. In a world where data flows at the speed of electrons, doctors and nurses and other providers have unprecedented access to new ways of getting information and providing care to patients.

The issue of hospitals blocking access to social media like Facebook and Twitter has been a topic of debate. It’s time we address this matter with open minds.

You can catch up on this story if you need to here:

Before discussing hospital blocking of social media, let’s take a quick look at some general observations about our world:

  • Rates of technological change always exceed rates of cultural change
  • Human and organizational psychologies often convert legitimate concerns into irrational fears
  • The Web is an unstoppable media-producing medium
  • Communication, social exchange and information are critical components of Healthcare

Do you see where I’m going with this?

I know about privacy. And HIPAA. And patient dignity. (In fact, I’ve even had to fight hospital administrators over that last part.)

What I’m saying is: I know how important and concerning these matters are to administrators. They’re not “wrong” in being concerned. It’s the fear which is a problem.

I also know what it’s like to work in an environment with horrible information systems – systems that are disconnected from a world – literally a world – of information, crowd-sourcing and expert curation.


Facebook is a security problem.

You know what’s a security problem in hospitals? Ignorance. Misinformation. Fear.

Facebook is a risk.

You know what’s risky? Surgery. Suction tubes. Insulin pumps. Hospital acquired infections.

Surgery can kill you with the wrong cut. Facebook can’t.

Suction tubes can tear your lung tissue. Facebook can’t.

Insulin pumps can shunt you into hypoglycemia and kill you. Facebook can’t.

Hospital acquired infections kill approximately 100,000 people admitted to hospitals per year (that’s practically genocidal). Facebook can’t.

Healthcare has always had to address risk. What makes Facebook so more frightening than a hospital admission?

You know what else is risky? As more of the world uses social media as the leading way to publish and consume breaking news, it becomes easier and easier to miss critical alerts if you’re not monitoring Twitter or Facebook or other media.

Imagine a national disaster and hospitals are asked to partake in efforts, some of which are conducted via Twitter or other public media. Do you want to be in a hospital that has to take last-minute measures with IT to get connected?

See where else I’m going?


I can’t speak for other Healthcare professionals about whether or not we have a duty to learn about the Web and 21st Century communications.

But I will speak for myself: I took an oath to protect patients. And even though I don’t practice at the bedside, I consider my work and opinions and evangelism of the dangers and opportunities of the Web as extensions of my oath. I consider it my public health duty to do my best to explore, learn and question as much I as can about the Web.

In other words, I’ve done my best to bring a nursing perspective of the human condition to our understanding and use of the Web. And I have online colleagues who are doing that everyday.


Should Hospitals block Facebook?

That’s not really the question. Here’s the question:

Should hospitals block the 21st Century?

If they can, then that means they have access to technologies which can also probably cure all disease from the face of the earth.

Then they’d be out of business, and we wouldn’t have to fret about their policies over staples of mainstream communication like Facebook and Twitter. 🙂

And here’s the fiduciary responsibility part: the more comfortable a business is using social media internally, you know what happens? It becomes more proficient in marketing and public relations in our time.

Management is morally obligated to ensure the best care for patients. It’s also legally obligated to do what’s right for Investors.

They’re the ones with capital.

Which is to say: they are the ones who ultimately decide who keeps their job.

It’s a rough economy. Attention is a scarce resource.

Doing your best to know what century you’re in is never a bad career move.

by @PhilBaumann – @RNchat@HealthIsSocial

Recommended post: Inteview by @MarkRaganCEO on Executive Fear of Social Media

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22 Replies to “Hospitals Can Block Facebook But Not the 21st Century”

  1. These are great points. I often say that health care providers who are not keeping up with social media are, in effect, unethical in their practice. We now know that 60% of Americans search for medical information online. If hospitals and providers refuse to be online, are we serving our patients’ best interest? And as some of the most highly educated individuals in the world, we can certainly figure out how to use social media. Learning to save lives is much more complicated.

    1. Thank you, Susan.

      Yes, it’s very important we fold these communication skills into our professional development.

      Like I said in my post, I won’t say providers have an ethical duty – I’ll leave that up for wider discussion – for from my view, my personal perspective, I consider being sufficiently web-literate a fundamental set of skills as important as reading and writing was for the last hundreds of years.

      Just like doctors and nurses supplemented their learning with books, the Web will be the way future providers will learn and communicate and share.

      Technological change always happens faster cultural change. That’s the dominant issue imo.


  2. A good job of putting things in perspective. Conversation doesn’t kill.

    But it’s interesting how frightening communication can be to people whose careers depend on getting things right. Letting go of the control they have with other forms of communication can be really uncomfortable for them. I think it will become easier as there are more models for them to follow. It’s easy to ignore Facebook, for instance, when you see another hospital or clinic posting announcements on their Wall and not allowing comments. Why not just stick with newsletters. But when you can point to enough FB pages, blogs or videos where the followers are engaged and obviously benefiting from the experience, that provides proof of the medium’s effectiveness.

    Blogs like this one help lead the way.

    1. Thanks, Lisa

      Yes, I do think it’s frightening for those who have grown accustomed to working in a world where the technological conditions of media were more controllable.

      Now, it’s being flipped. So, I think what will be needed is a lot of effort on the part of traditional communications professionals to step back, take a look at how things are changing and develop a chart of what needs to be learned.

      So, yes: for many organizations, this is a frightening century.


  3. You mentioned hospital-acquired infections, but what about the viruses that may be unleashed via Facebook, LinkedIn etc. You glossed over these concerns by ridiculing hospital administrators, but I have yet to see a marketing professional adequately address these security concerns. A rogue employee with a cell-phone camera is one type of HIPPA violation in the making, but a vicious computer virus delivered via Facebook has the potential of racking up thousands of violations in one “swell foop.” So what do we do with that argument?

    1. @ButWhatAbout

      I’m glad that you raised that, ButWhatAbout.

      Those are very valid concerns and they weren’t dismissed in the post at all. I did not go into them, true, but those are part of “intelligently adapting to the technological and communications conditions of today”.

      There are other considerations which I didn’t address, such as employees wasting time, etc.

      But those are for another post.

      The essence of the points made here goes to the general disposition and attitude of certain hospitals that may be focusing more on the negatives, or low on resources to develop a well-rounded policies.

      Sometimes, it’s just easier to block things than it is to invest the time and effort to figure out how to do them safely and usefully.

      Just like the matter of paper versus electronic records, there are still people out there who just won’t give up paper because the of the risks and difficulties of adopting better ways of doing things.

      If you want to eliminate all risk, don’t do anything. Actually, that doesn’t work either.

      My suggestion is to not only train employees on the uses of these media, but actually encourage them to use it in the right contexts. Rather than fighting against a current, learn to swim .

      Rogue employees are going to do what they do – they’ll find other ways to do what they do.

      [Disclosure: I don’t like Facebook. But it is a mainstay of today’s communications – to just outright block it seems reflective of a more general fear of the 21st Century.

      I’ve taken hard looks at Facebook before, which you can read here: ]

      But regardless of my personal views, I continue to maintain that hospitals need to seriously consider *all* aspects of adoption. Like I said earlier – often legitimate concerns get magnified into fears.

      Excellent point, ButWhatAbout. Thank you.

    2. Too funny. That link is blocked!
      Thanks for seeing my frustration. “…intelligently adapting to the technological and communications conditions of today…” is definitely the issue in my workplace. “They” do not want to spend the $$ to upgrade our system’s security. “They” even have a problem with using Constant Contact or a similar service over security fears becaue of viruses.

  4. I agree with Paul Levy that blocking FB won’t stop stupidity. But I haven’t had access to FB in my GP practice for more than a year and I can’t think that it has had any impact on my clinical work. If twitter was blocked it wouldn’t make any difference either. We should be realistic about the clinical utility of these tools. This doesn’t mean that other appropriate tools won’t come along, of course.

    1. Beter tools will come along. What we have not is rather primitive.

      One more reason for leaders of large organizations to get a better handle on what’s happening.

  5. Ive been using . It uses a better method than blocking social media sites because it only monitors sites like Facebook in working hours. people/employees can still use it for a breather, during lunch breaks and sometimes they use it for work too so its really unecessary to block it.

  6. I appreciate your view from a clinical perspective as this has been constant topic of discussion over the past 9-12 months in the organization where I work.  One of the biggest concerns for nursing is that if social media sites are enable then the clinical staff will begin accessing these sites on publicly viewable PCs. I would interested to know how other organizations are tackling this issue.

    1. It’s not a clean-cut issue, but hospitals will increasingly need to address it holistically – by outright blocking social media sites, they are losing several opportunities, including ‘teaching moments’ for training staff on the proper use of SM at work. Furthermore, what happens if there’s a disaster where the primary flows of needed information and outreach are via social media (where clinical staff – not just PR – needs to be involved)?
      Some hospitals are addressing these concerns. Not many – most still block. But I think in 2012 and 2013 we’ll start to see more initiatives on how to get there.

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