DCA05DE Dental Ethics and the Digital Age, 3rd Edition _ _________________________________________
guidelines to the greatest extent possible. These boundaries promote a safe space where patients can trust, respect, and feel confident about their dental health provider and the care that they are receiving. It has been suggested that dental pro- viders keep their personal and professional content separate (Howley, 2019). PRIVACY ISSUES The Internet is very public, so privacy is another primary concern for patients and providers when using social media. Dental professionals must, therefore, think before they post. According to the U.S. Department of Health and Human Services (HHS, n.d.b.), the strict regulations of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 protect patients’ personal health information. Also to be considered is the ethical obligation under dental professional codes to maintain patient confidentiality. The ADA Code (Confidentiality of Patient Records) and the ADHA Code (Core Values) specifically address privacy. Social media presents the difficult challenge of keeping patient infor- mation private. Most dental providers would never think of intentionally post- ing patient names and associated dental conditions or medical histories online via a social media site. That would be a blatant breach of patient confidentiality and is contrary to their ethical obligations. Consider the following case. CASE STUDY 2 Dr. P is a dentist whose patient, Roger, came to see him with a frac- tured tooth #8. Roger is a well-respected local businessman who owns a very expensive motorcycle. Roger admitted to Dr. P that he had too much to drink the other night, drove the motorcycle into a tree, and totaled it. Roger was lucky that he walked away with only a fractured tooth and a few scratches and bruises. Dr. P had been pondering getting a motorcycle, but after hearing what happened to Roger, he changed his mind. Later that evening, Dr. P went on Facebook and proclaimed, “No motorcycle for me! I see what can happen when you crash your bike into a tree. Too bad. That was a nice bike and a beautiful tooth! I don’t think the scotch and water was worth it, but what do I know?” A few days later, Roger called Dr. P and was livid about the Facebook post. Roger’s wife, who was a Facebook friend with Dr. P’s wife, saw the post and told Roger about it. Although Dr. P did not mention any names in his Facebook post, several people inferred that the post was about Roger. Before long, the post was “liked” and “shared” several times. Roger feared that his reputation in town might be ruined. Dr. P felt terrible, but the damage was already done. 1. What are the ethical implications of dental professionals sharing patient-related information on social media? 2. How can a well-defined office social media policy help prevent breaches of patient confidentiality?
In such a situation, sensitive information can be revealed on a social media site even without specifying names. Dental professionals must exercise extreme caution when posting anything remotely connected to a patient on public forums that would allow identification by association. Increasingly, more professional societies are setting standards regarding the use of social media and the Internet in professional practice. The ADA offers guidance on creating social media policies for dental offices (https://www.ada.org/resources/practice/ practice-management/social-media-policies-for-dentists). A robust office policy is crucial as it assists compliance for dentists and staff alike, providing a clear and supportive framework. Once in cyberspace, such remarks cannot be retrieved (Bahabri and Zaidan, 2021). TELEDENTISTRY Telemedicine, or virtual doctor visits, is a new phenomenon more common in medicine than dentistry. Texting, video conferencing, and email are just ways that patients can interact and converse with their healthcare providers, eliminating the need to be physically present at an office visit. The COVID- 19 pandemic undoubtedly increased the availability and use of telemedicine and teledentistry. In 2020, the estimated amount spent on these services was 10 billion dollars, which is estimated to reach 43 billion dollars by 2026 (Arizton, 2021). In 2020, the American Dental Association published a Policy on Teledentistry. (See the Resources section of this course, https://www.ada.org/about/governance/current-policies/ ada-policy-on-teledentistry, 2020.) This policy concerns the use of various technologies and tactics for delivering virtual dental health care, education services, and the transmission of images. This combination of telecommunications and dentistry allows for the exchange of clinical information and images over remote distances for consultation and treatment planning. Teledentistry is an asset in places where access to care is an issue or patients are unable to get to the office for various reasons. The ADA indicates that teledentistry can include, but is not limited to, the following modalities (American Dental Association, 2020): • Synchronous (live video): Real-time, two-way interaction between a patient, caregiver, or provider and provider via audiovisual technology. • Asynchronous (store and forward): Recorded health data (e.g., radiographs, photos, videos) sent through a secure system to a practitioner for evaluation or service outside of real-time interaction. • Remote Patient Monitoring (RPM): Collection and transmission of personal health data from one location to a provider in another location for care and support.
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