Physicians have written about patient cases for their peers and for the general public for years and years.  Oliver Sacks, Atul Gawande and the weekly case report from MGH in the New England Journal of Medicine come to mind as current examples of this long tradition.  This thing we call the blogoshere, though, due to its speed and informality, raises the potential of inadvertent breaches of patient confidentiality (and, of course, the potential for liability under HIPAA and state laws).  A recent entry in iHealthBeat notes:

Physicians and other health care workers are attracted to blogs because of the anonymity they provide. While some medical bloggers write on uncontroversial topics, others use the outlet to discuss patients, sometimes in graphic or crude detail, according to the [Detroit] Free Press.

And therein lies the potential problem.  Education, as well as adoption and enforcement of blogging policies by physician organizations and institutions, can help protect medical bloggers from potentially overstepping the bounds of propriety — and the law.

But who will keep Google in check?  The latest from the Googleplex is news of AdSense-funded free EHRs for physicians.  Google says physicians can nix the ads by paying a $250 monthly fee.  I know Google says they don’t read the content of the EHRs (just as they don’t read your gmail, etc.), they just analyze it in order to feed you targeted ads.

With a tip of the hat to John Christiansen, one must ask: if a physician who opts for the ad-subsidized version orders a federally-reimbursed service or product whose ad pops up next to a patient’s EHR, are we in anti-kickback territory? 

David Harlow