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DIGITAL CITIZENSHIP
FOR PHYSICIANS
Joyce Lee, MD, MPH
Twitter: @joyclee
www.doctorasdesigner.com
Current:
JAMA Pediatrics, Social
Media, Web Editor
Unitio
Previous:
Verily
Samuelsson Associates
@joyclee #hcsm
Q: Are there any other uses of social media in
clinical medicine or research that you want to learn
about?
A: “No. This is...
Twittersuperuser.com
YOU ARE A
DIGITAL CITIZEN
“A person utilizing information
technology (IT) in order to engage in
society, politics, and gov...
“The Good Old Days”
@joyclee #hcsm
DOYOU HAVE A
CELLPHONE?
(1) Yes
(2) No
@joyclee #hcsm
PIECES OFYOU ARE
ALREADYALL OVER THE
INTERNET
“A world of indiscriminate
tracking where institutions
are stockpiling data about
individuals
Manoush Zomorodi
privacy-paradox.org
@joyclee #hcsm
WHAT DOES YOUR PHONE
KNOWABOUTYOU?
Metadata=Data about data
Time of a call or text
Incoming or outgoing
Duration of the call
Length of the text message
Phone # of senders & recipient...
Metaphone=Android smartphone application
• The application automatically retrieved
– Historical call and text message [Sho...
We randomly selected 30,000 numbers from our
dataset and queried free, public interfaces hosted by
Yelp, Google Places, an...
Random selection of 250 phone numbers
• Manual query interface for an inexpensive
commercial database (Intelius; $19.95 a ...
80% Accuracy in Identifying a
Romantic Partner
Studied participants who according to their Facebook
profile were single N ...
“Participant A held conversations with a
pharmacy specializing in chronic care, a
patient service that coordinates
managem...
“Participant B received a long phone
call from the cardiology group at a
regional medical center, talked briefly
with a me...
“Participant E made a lengthy phone call
to her sister early one morning. Then, 2
days later, she called a nearby Planned
...
Metadata from an NSA request involving
a single suspect could uncover
information on approximately 25,000
individuals.
Ext...
@joyclee #hcsm
Challenge #1:
TAKE BACKYOUR
METADATA
@joyclee #hcsm
DOYOU USE GOOGLE?
(1) Yes
(2) No
Incognito mode only deletes your local
search and browsing history - just the
content on your computer.
Websites, search e...
@joyclee #hcsm
DOYOU USE GMAIL,
DRIVE, DOCS, MAPS,
PHOTOS?
(1) Yes
(2) No
@joyclee #hcsm
WHAT DOESN’T
KNOWABOUTYOU?
http://www.pbs.org/wgbh/frontline/film/united-states-of-secrets/#video-2
http://www.pbs.org/wgbh/frontline/film/united-states-of-secrets/#video-2
@joyclee #hcsm
Challenge #2:
DUCK GOOGLE FOR
DUCK DUCK GO
“zero-data-retention policy”
https://myaccount.google.com/activitycontrols
@joyclee #hcsm
DOYOU USE
FACEBOOK?
(1) Yes
(2) No
@joyclee #hcsm
YOUR IDENTITYIS BEING
DEFINED & TRACKED BYAN
ALGORITHM
The Facebook algorithm
https://chrome.google.com/webstore/detail/what-facebook-thinks-
you/eoknmaajkanapojcdeccofmeimpddoim
1. What you do on FB
2. What you do on other websites
3. Personal data purchased from
offline data brokers (mortgages, car...
Facebook offers advertisers >1,300
categories for ad targeting:
Email, location, sexual preference,
community information,...
Orbitz = higher prices for hotels for Mac
computer users
Staples = higher prices in certain ZIP codes.
The Princeton Revie...
@joyclee #hcsm
Challenge #3:
USE THE WHAT FACEBOOK
THINKS YOU LIKE TOOL
What does this mean for your online
identity as an...
@joyclee #hcsm
DOYOU USE SIRI,
ALEXA, ECHO, OR
GOOGLE HOME?
(1) Yes
(2) No
There’s no user-accessible record of your
previous queries because Apple associates
them with a random ID number, rather t...
”Amazon maintains a database of your
conversations with the Echo, which you can
see and manage online. In addition, audio ...
@joyclee #hcsm
PIECES OFYOU ARE
ALREADYALL OVER THE
INTERNET
@joyclee #hcsm
ARE THOSE
PRIVATE PIECES OR
PUBLIC PIECES?
@joyclee #hcsm
CAN YOU SEPARATEYOUR
PRIVATE AND PUBLIC
IDENTITYAS A PHYSICIAN?
(1) YES
(2) NO
When a physician asks, “Should I post this
on social media?” the answer does not
depend on whether the content is
professi...
@joyclee #hcsm
YOU HAVE NO CONTROL
OVER WHAT HAPPENS
TOYOU ON THE
INTERNET
@joyclee #hcsm
YOU ARE A
PUBLIC PHYSICIAN
@joyclee #hcsm
YOU NEED TO MANAGE
THE MECHANICS AND
CONTENT OF SHARING
ONLINE
Iceberg Tweeting
@craigmod Link
Text
Date, Time
Retweet
Favorite
Individuals
Photo/Video
Replies
No risks outlined on the
Youtube Twitter Card metatags!
@joyclee #hcsm
Challenge #4:
RULES AND ETIQUETTE
“Due to your clenching and grinding habit, this
is not the first molar tooth you have lost due to
a fractured root…This to...
“You brought your daughter in for the
exam in early March 2014,” he wrote.
“The exam identified one or more of the
signs I...
3
4
4
5
“5 nurses who worked at Tri-City Medical
Center in Oceanside, CA used social
media to post their personal discussions
conc...
7
8
9
10
11
Director, Chief Operating Officer of the Cleveland
Clinic Wellness Institute12
12
”Hey I will send you an email
with the patient’s info”
13
“I will add it to google drive”
14
“He wrote this opinion piece on his own
and it does not reflect the position of the
Cleveland Clinic whatsoever, and we
st...
EVERYHEALTHCARE PROFESSIONAL IS
THE VOICE OF HIS/HER INSTITUTION
”Disclaimer or not, logo or no logo, the world knew that
...
DOYOU EXIST IFYOU
ARE NOT ONLINE?
GO FORTH AND BE A
GOOD DIGITAL CITIZEN!
joyclee@med.umich.edu
http://www.doctorasdesigner.com/
Twitter: @joyclee
https://m...
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
Digital Citizenship for Physicians
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Digital Citizenship for Physicians

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My talk about digital citizenship and social media for 4th year medical students at the University of Michigan.

Published in: Health & Medicine
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Digital Citizenship for Physicians

  1. 1. DIGITAL CITIZENSHIP FOR PHYSICIANS Joyce Lee, MD, MPH Twitter: @joyclee www.doctorasdesigner.com
  2. 2. Current: JAMA Pediatrics, Social Media, Web Editor Unitio Previous: Verily Samuelsson Associates @joyclee #hcsm
  3. 3. Q: Are there any other uses of social media in clinical medicine or research that you want to learn about? A: “No. This is a complete waste of time. This is not real research. The fad will die out soon.”
  4. 4. Twittersuperuser.com
  5. 5. YOU ARE A DIGITAL CITIZEN “A person utilizing information technology (IT) in order to engage in society, politics, and government participation.”
  6. 6. “The Good Old Days”
  7. 7. @joyclee #hcsm DOYOU HAVE A CELLPHONE? (1) Yes (2) No
  8. 8. @joyclee #hcsm PIECES OFYOU ARE ALREADYALL OVER THE INTERNET
  9. 9. “A world of indiscriminate tracking where institutions are stockpiling data about individuals
  10. 10. Manoush Zomorodi privacy-paradox.org
  11. 11. @joyclee #hcsm WHAT DOES YOUR PHONE KNOWABOUTYOU? Metadata=Data about data
  12. 12. Time of a call or text Incoming or outgoing Duration of the call Length of the text message Phone # of senders & recipients METADATA @joyclee #hcsm
  13. 13. Metaphone=Android smartphone application • The application automatically retrieved – Historical call and text message [Short Message Service (SMS)] metadata from device logs – Information from a participant’s Facebook account, to be used as ground truth for potential inferences. • 823 participants volunteered their metadata, which included 251,788 calls and 1,234,231 text messages
  14. 14. We randomly selected 30,000 numbers from our dataset and queried free, public interfaces hosted by Yelp, Google Places, and Facebook using these numbers 31.9% of phone numbers can be reidentified (automated)
  15. 15. Random selection of 250 phone numbers • Manual query interface for an inexpensive commercial database (Intelius; $19.95 a month ). • Manual Google web searches to look for identifying information (70 min) 82% of phone numbers can be reidentified (automated & manual)
  16. 16. 80% Accuracy in Identifying a Romantic Partner Studied participants who according to their Facebook profile were single N = 148 or in a relationship N = 309.
  17. 17. “Participant A held conversations with a pharmacy specializing in chronic care, a patient service that coordinates management for serious conditions, several local neurology practices, and a pharmaceutical hotline for a prescription drug used solely to manage the symptoms and progression of relapsing- remitting multiple sclerosis.”
  18. 18. “Participant B received a long phone call from the cardiology group at a regional medical center, talked briefly with a medical laboratory, answered several short calls from a local drugstore, and made brief calls to a self-reporting hotline for a cardiac arrhythmia monitoring device.”
  19. 19. “Participant E made a lengthy phone call to her sister early one morning. Then, 2 days later, she called a nearby Planned Parenthood clinic several times. Two weeks later, she placed brief additional calls to Planned Parenthood, and she placed another short call 1 month after.”
  20. 20. Metadata from an NSA request involving a single suspect could uncover information on approximately 25,000 individuals. Extend the search by one degree of separation — you, your friend and their contacts — and an agent could recover personal information on 20 million people.
  21. 21. @joyclee #hcsm Challenge #1: TAKE BACKYOUR METADATA
  22. 22. @joyclee #hcsm DOYOU USE GOOGLE? (1) Yes (2) No
  23. 23. Incognito mode only deletes your local search and browsing history - just the content on your computer. Websites, search engines, internet service providers, and governments can still easily track you across the web. “BUT I SURF INCOGNITO!”
  24. 24. @joyclee #hcsm DOYOU USE GMAIL, DRIVE, DOCS, MAPS, PHOTOS? (1) Yes (2) No
  25. 25. @joyclee #hcsm WHAT DOESN’T KNOWABOUTYOU?
  26. 26. http://www.pbs.org/wgbh/frontline/film/united-states-of-secrets/#video-2
  27. 27. http://www.pbs.org/wgbh/frontline/film/united-states-of-secrets/#video-2
  28. 28. @joyclee #hcsm Challenge #2: DUCK GOOGLE FOR DUCK DUCK GO
  29. 29. “zero-data-retention policy”
  30. 30. https://myaccount.google.com/activitycontrols
  31. 31. @joyclee #hcsm DOYOU USE FACEBOOK? (1) Yes (2) No
  32. 32. @joyclee #hcsm YOUR IDENTITYIS BEING DEFINED & TRACKED BYAN ALGORITHM The Facebook algorithm
  33. 33. https://chrome.google.com/webstore/detail/what-facebook-thinks- you/eoknmaajkanapojcdeccofmeimpddoim
  34. 34. 1. What you do on FB 2. What you do on other websites 3. Personal data purchased from offline data brokers (mortgages, car ownership and shopping habits) @joyclee #hcsm
  35. 35. Facebook offers advertisers >1,300 categories for ad targeting: Email, location, sexual preference, community information, likes “grass”, likes “wax”; property size less than .26 acres; households with 7 credit cards @joyclee #hcsm
  36. 36. Orbitz = higher prices for hotels for Mac computer users Staples = higher prices in certain ZIP codes. The Princeton Review = Higher charges for online SAT tutoring course in certain ZIP codes: $6,600 vs. $8,400. @joyclee #hcsm
  37. 37. @joyclee #hcsm Challenge #3: USE THE WHAT FACEBOOK THINKS YOU LIKE TOOL What does this mean for your online identity as an individual/MD?
  38. 38. @joyclee #hcsm DOYOU USE SIRI, ALEXA, ECHO, OR GOOGLE HOME? (1) Yes (2) No
  39. 39. There’s no user-accessible record of your previous queries because Apple associates them with a random ID number, rather than your email address or iCloud account. After six months, both are deleted.
  40. 40. ”Amazon maintains a database of your conversations with the Echo, which you can see and manage online. In addition, audio data is encrypted when it enters and leaves your home, to minimize the risk of interception by hackers”
  41. 41. @joyclee #hcsm PIECES OFYOU ARE ALREADYALL OVER THE INTERNET
  42. 42. @joyclee #hcsm ARE THOSE PRIVATE PIECES OR PUBLIC PIECES?
  43. 43. @joyclee #hcsm CAN YOU SEPARATEYOUR PRIVATE AND PUBLIC IDENTITYAS A PHYSICIAN? (1) YES (2) NO
  44. 44. When a physician asks, “Should I post this on social media?” the answer does not depend on whether the content is professional or personal but instead depends on whether it is appropriate for a physician in a public space
  45. 45. @joyclee #hcsm YOU HAVE NO CONTROL OVER WHAT HAPPENS TOYOU ON THE INTERNET
  46. 46. @joyclee #hcsm YOU ARE A PUBLIC PHYSICIAN
  47. 47. @joyclee #hcsm YOU NEED TO MANAGE THE MECHANICS AND CONTENT OF SHARING ONLINE
  48. 48. Iceberg Tweeting @craigmod Link
  49. 49. Text Date, Time Retweet Favorite Individuals Photo/Video Replies
  50. 50. No risks outlined on the Youtube Twitter Card metatags!
  51. 51. @joyclee #hcsm Challenge #4: RULES AND ETIQUETTE
  52. 52. “Due to your clenching and grinding habit, this is not the first molar tooth you have lost due to a fractured root…This tooth is no different.” I looked very closely at your radiographs and it was obvious that you have cavities and gum disease that your other dentist has overlooked. … You can live in a world of denial and simply believe what you want to hear from your other dentist or make an educated and informed decision -Dentist 1
  53. 53. “You brought your daughter in for the exam in early March 2014,” he wrote. “The exam identified one or more of the signs I mentioned above for scoliosis. I absolutely recommended an x-ray to determine if this condition existed; this x- ray was at no additional cost to you” -Chiropractor 2
  54. 54. 3
  55. 55. 4
  56. 56. 4
  57. 57. 5
  58. 58. “5 nurses who worked at Tri-City Medical Center in Oceanside, CA used social media to post their personal discussions concerning hospital patients. No photos, patients names, or other identity- compromising information were posted.” 6
  59. 59. 7
  60. 60. 8
  61. 61. 9
  62. 62. 10
  63. 63. 11
  64. 64. Director, Chief Operating Officer of the Cleveland Clinic Wellness Institute12
  65. 65. 12
  66. 66. ”Hey I will send you an email with the patient’s info” 13
  67. 67. “I will add it to google drive” 14
  68. 68. “He wrote this opinion piece on his own and it does not reflect the position of the Cleveland Clinic whatsoever, and we strongly support vaccinations and the protection of patients and employees,” said Eileen Sheil, executive director of corporate communications for the medical center.
  69. 69. EVERYHEALTHCARE PROFESSIONAL IS THE VOICE OF HIS/HER INSTITUTION ”Disclaimer or not, logo or no logo, the world knew that this doctor was leadership at The Cleveland Clinic.” “Our public engagement is inextricably linked to our work and other aspects of our lives.” “Welcome to the age of transparency.” @Doctor_V
  70. 70. DOYOU EXIST IFYOU ARE NOT ONLINE?
  71. 71. GO FORTH AND BE A GOOD DIGITAL CITIZEN! joyclee@med.umich.edu http://www.doctorasdesigner.com/ Twitter: @joyclee https://medium.com/@joyclee

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