Tweeting While Treating

I was working an overnight ED shift recently (actually, I only work overnight shifts–aren’t you envious?) and I said to myself,” self, why don’t I send out tweets in real time during the shift?” Well, not 100% real time. I’m not interrupting patients or pausing CPR to hit the send button or anything. At least as far as you know….

So the concept is this: live clinical tweets. So far this has simply involved sending out pearls and pitfalls related to the cases I see on my night shift. Simple. No patient identifiers. And, so far, no images…just words.


The more I thought about it the more I started thinking,”Is there anything else I could add to the pearls that go out?” What about a good 12 lead ECG finding? Wouldn’t that be cool? What about a quick rash pearl with a picture of the rash. Hey, I just had a great Ramsay Hunt case…why not send out a picture of the ear vesicles and/or the facial palsy?

The more I thought about it the more frustrated I became, because I realized I couldn’t send out many of these things because of patient privacy and HIPAA (Health Insurance Portability and Accountability Act). Essentially, because of the inherent dangers of posting any potentially sensitive information on social media, my hands are tied. Or are they? Maybe  I am just paranoid because of recent stories I have heard of doctors posting information on Facebook, Twitter, etc. We obviously have to be careful about anything we post that relates to patient care. How much can we post in the name of education? Does getting patient permission matter? How much can you show? The face? a rash on the torso? These are questions we need to think about before we can post “live” educational tweets.

In the meantime, I decided that certain things would be great for posting. Quick, down and dirty, useful ED teaching pearls. Using the Vine app for iPhone I took a quick little video of how to mix fluorscein in a syringe so that you don’t have to slap a piece of paper in someone’s eye when you need to rule out a corneal abrasion.

So, my question to the FOAM collective is what should be allowed to post to Twitter, or Facebook, or any other social media venue? Or, is this just a bad idea and a patient privacy catastrophe waiting to happen?


I am hoping this generates some great discussion…

The future: What about live video feeds from the ED on overnight shift using the LiveStream Broadcaster? Wouldn’t that be cool? Live teaching pearls via live video feed…That is one that will take some time to work on….but, I am working on it. broadcaster2


So, what can you do?

1. Post some comments to get the discussion started.

2. Follow live ED educational tweets: UMEM Live-Tweeting While Treating (#UMEMlive)


Leave a Reply

Your email address will not be published. Required fields are marked *