Koh Steve, Cattell Gwyn M, Cochran David M, Krasner Aaron, Langheim Frederick J P, Sasso David A
University of California, San Diego, Department of Psychiatry, 9500 Gilman Drive, MC 0993, La Jolla, CA 92093, USA.
J Psychiatr Pract. 2013 May;19(3):254-63. doi: 10.1097/01.pra.0000430511.90509.e2.
Recent and ongoing advances in information technology present opportunities and challenges in the practice of medicine. Among all medical subspecialties, psychiatry is uniquely suited to help guide the medical profession's response to the ethical, legal, and therapeutic challenges--especially with respect to boundaries--posed by the rapid proliferation of social media in medicine. Ironically, while limited guidelines exist for other branches of medicine, guidelines for the responsible use of social media and information technology in psychiatry are lacking.
To collect data about patterns of use of electronic communications and social media among practicing psychiatrists and to establish a conceptual framework for developing professional guidelines.
A structured survey was developed to assess the use of email, texting, and social media among the active membership of the Group for the Advancement of Psychiatry (GAP) to gain insight into current practices across a spectrum of the field and to identify areas of concern not addressed in existing guidelines. This survey was distributed by mail and at an annual meeting of the GAP and a descriptive statistical analysis was conducted with SPSS.
Of the 212 members, 178 responded (84% response rate). The majority of respondents (58%) reported that they rarely or never evaluated their online presence, while 35% reported that they had at some time searched for information online about patients. Only 20% posted content about themselves online and few of these restricted that information. Approximately 25% used email to communicate with patients, and very few obtained written consent to do so.
Discipline-specific guidelines for psychiatrists' interactions with social media and electronic communications are needed. Informed by the survey described here, a review of the literature, and consensus opinion, a framework for developing such a set of guidelines is proposed. The model integrates four key areas: treatment frame, patient privacy, medico-legal concerns, and professionalism. This conceptual model, applicable to many psychiatric settings, including clinical practice, residency training, and continuing medical education, will be helpful in developing discipline-wide guidelines for psychiatry and can be applied to a decision-making process by individual psychiatrists in day-to-day practice.
信息技术领域近期及持续的进展给医学实践带来了机遇与挑战。在所有医学亚专业中，精神病学特别适合帮助引导医学界应对社交媒体在医学领域迅速扩散所带来的伦理、法律和治疗方面的挑战，尤其是在界限方面。具有讽刺意味的是，虽然其他医学分支的指导方针有限，但精神病学中关于负责任地使用社交媒体和信息技术的指导方针却付诸阙如。
收集执业精神科医生使用电子通信和社交媒体的模式数据，并建立一个用于制定专业指导方针的概念框架。
设计了一项结构化调查，以评估精神病学促进协会（GAP）活跃会员使用电子邮件、短信和社交媒体的情况，以便深入了解该领域当前的做法，并确定现有指导方针未涉及的关注领域。该调查通过邮件以及在GAP的年度会议上进行分发，并使用SPSS进行描述性统计分析。
在212名成员中，178人做出了回应（回应率为84%）。大多数受访者（58%）表示他们很少或从不评估自己的网络形象，而35%的受访者表示他们曾在网上搜索过有关患者的信息。只有20%的人在网上发布过关于自己的内容，其中很少有人对这些信息进行限制。约25% 的人使用电子邮件与患者沟通，而且很少有人为此获得书面同意。
需要针对精神科医生与社交媒体和电子通信互动的特定学科指导方针。基于此处描述的调查、文献综述和共识意见，提出了一套制定此类指导方针的框架。该模型整合了四个关键领域：治疗框架、患者隐私、法医学问题和专业精神。这个概念模型适用于许多精神病学场景，包括临床实践、住院医师培训和继续医学教育，将有助于制定全学科的精神病学指导方针，并可应用于个体精神科医生日常实践中的决策过程。
