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A nurse at a Texas children’s hospital has been fired for violating Health Insurance Portability and Accountability Act (HIPAA) Rules by posting protected health information on a social media website.

The pediatric ICU/ER nurse worked at Texas Children’s Hospital and posted a series of comments on Facebook about a rare case of measles at the hospital. The nurse was an anti-vaxxer and posted about the experience of seeing a boy at the hospital suffering from the disease – a disease that could have been prevented through vaccination.

Her comments explained how the disease was much worse that she expected it to be, having not encountered anyone with the measles in the past. She explained that it was a “rough” experience seeing the boy suffering from the disease.

She also explained in her posts, “I think it’s easy for us non-vaxxers to make assumptions, but most of us have never and will never see one of these diseases,” and “By no means have I changed my vax stance, and I never will. But this poor kid was bad off and as a parent, I could see vaccinating out of fear,” as reported by the Houston Chronicle, which obtained screenshots of her Facebook posts.

Due to a high rate of vaccination (94.5%) in Houston, a measles case is very rare. Over the past ten years there have fewer than 10 confirmed cases in the city. While the nurse did not post the child’s name on Facebook, her job was listed on her profile along with the hospital where she worked, and information about the boy and his condition. Due to the information contained in the posts and the rarity of the disease, it is possible that the child could have been identified.

Texas Children’s Hospital suspended the nurse when officials found out about her social media posts and an investigation was launched. After receiving the suspension, the nurse appeared to realize that she had shared too much information and deleted several of her posts. Four days after the nurse was suspended the decision was taken to fire her for the HIPAA violation. An official from Texas Children’s Hospital confirmed the nurse lost her job as a result of violating hospital policies and federal laws by posting protected health information on social media, and not for her anti-vaxxing views.

The HIPAA Privacy Rule places restrictions on the allowable uses and disclosures of protected health information. Most healthcare professionals will be well aware that the posting of any protected health information on a social media website constitutes a HIPAA violation.

However, as this incident shows, the patient does not need to be mentioned by name in order for them to potentially be identified. If any personally identifiable protected health information is posted on social media without consent first being obtained from the patient, it constitutes a violation of the HIPAA Privacy Rule.

A good rule of thumb is to keep work and private lives separate, and never to post any information about patients on a social media platform, even if you do not think that a patient could be identified from the post.

At HIMSS 2017, the former deputy director of health information privacy at the HHS’ Office for Civil Rights (OCR) explained that OCR plans to issue guidance on HIPAA and social media and what is and is not acceptable.