In June, The Ohio State University Medical Center joined a growing number of hospitals that have live-tweeted a surgery. The goals: to inform patients and referring physicians about the procedure and to educate medical students about orthopedics. A doctor skilled in minimally invasive knee replacement dictated the Twitter updates, while another surgeon performed the operation. The patient's family monitored his progress by tuning into the tweets.

"We had someone sitting with the patient's wife in a room and showing her the video and tweets" from a laptop, says Ryan Squire, social media program director at the medical center. They were able to view the tweets and video simultaneously on Ustream. "Instead of staring at a board that said, ‘In operating room,' his wife became an active participant." Meanwhile, the couple's children followed the tweets from far away. "Everyone was there for Dad," Squire says.

However, as tweeting and video streaming during surgeries gain momentum, hospitals face the potential for increased liability. Experts say there are ways to balance the use of social media while minimizing the inherent risks.

"The health care industry is beginning to explore the communication opportunities that social networking offers," says Michelle Hoppes, president of the American Society for Healthcare Risk Management. "Although there are advantages to using social media, there are also new risk exposures." She advises health systems and providers to "use extreme caution and to develop a risk-management approach before engaging in this new communication method."

Surgeons and assistants should not tweet while involved in a procedure, says Hoppes, who is also senior vice president of Sedgwick Claims Management Services Inc., Grand Ledge, Mich. If complications arise during an operation, there should be an emergency plan for managing tweets and video. Adhering to copyright and intellectual property laws is also important, as is obtaining the patient's informed consent and helping the hospital avoid HIPAA violations.

Three departments within an organization — the social media team, marketing and human resources — should collaborate on a tweeting policy, so that employees, patients and the public understand the expectations. "All three need to work together to mitigate risk, teach responsible use and move us into a more transparent environment to talk about safety, outcomes, patient satisfaction and quality," says Kristine Olson, vice president of Essentia Health's west region in Fargo, N.D. "We cannot jeopardize patient safety. That always comes first."

The rationale for providing Twitter updates and video should extend beyond marketing. "If you are tweeting during a surgery only to create positive PR, you run the risk of failing if something goes wrong," Squire says. When that happens, consider using "the moment to teach, to help people understand the risks inherent with surgery, and how surgeons and medical professionals are trained to respond to these situations."