ScenarioDisclosure of Personal Health Information

Communicating with a Client Via Email and Facebook

A client asks a dietitian specific questions about her nutrition care plan by email. She also asks a question on the dietitian’s professional Facebook page. What are the dietitian’s obligations for obtaining consent to communicate client personal health information via email and on social media?

A dietitian cannot assume that a client understands all the risks involved in disclosing personal health information online or posting it on social media. It is the dietitian’s responsibility to obtain an informed and knowledgeable consent from the client that would allow sharing their personal health information in an email or on social media (Refer to the Professional Practice Standard, Consent to Treatment, Standards 2).

The dietitian should clearly explain the security issues surrounding communicating via email and the measures they have in place to protect the client’s personal health information (encryption, password protection, etc.). Still, communicating over the internet is never 100% secure (Refer to Telephone & Web-Based Counselling) The dietitian can also explain the possibility for miscommunication online and the limits to communicating via email versus in person visits and conversations over the phone. 
With regards to social media, the dietitian should make sure that the client understands that the Facebook page is public and any personal health information posted there can be viewed by everyone. The dietitian may offer a private method of communication as an alternative. If the client understands the risks and consents to communicate via email or on social media, then the fact that the dietitian obtained an informed express consent to communicate online can be documented in the client's health record.