Alzheimer’s researcher Mark Smith: A holiday tragedy (Weekend Rounds)

“I bet you the word ‘douchebag’ was added” to the list of words flagged by the hospital’s filtering system, Cleveland Clinic spokesman Brian Kolonick said. “Maybe it was under the radar?”

Health IT is trickier than you’d think, particularly when you’re managing both employees who should focus on their work but also patients who expect to surf from their hospital beds like they are at home. Most health systems have public Internets and corporate ones. Many hospitals still wall off Facebook and YouTube to public and corporate access (even though they have an increasingly large presence on those sites).Cleveland Clinic patients can access YouTube and Facebook. Meanwhile, employees can access Facebook. YouTube, however, is almost completely off-limits to all staff (as are sites like Skype and Pandora).

Sites like YouTube are nixed because of bandwidth issues more than for the content itself. Other sites have innocuous information but are barred because they may carry hidden software that can damage a computer system.

Content — and what’s acceptable content — is an ever-changing line.

“Looking at the issue from a technology perspective, it is very difficult to implement ‘How am I going to define what sites are going to be viewed and what sites are not going to be viewed,’ ” said David Kelleher, communications and research analyst for Internet security company GFI Software. Most companies, like Cleveland Clinic, use software to monitor and block sites. Some businesses outline a fixed amount of online “social time” for employees to visit non-work sites, Kelleher said.

But Kelleher said the issue remains: How do you define what the employees can or can’t view?

Exhibit A: Hot Chicks With Douchebags. “Douchebag” was a low-end, under-the-radar derogatory word known more for the literal, medicinal application. That changed in recent years with the evolution of muscle-bound and fake-tanned devotees, and the sites that loathe them. Then came the expansion of TV shows like Jersey Shore and Is She Really Going Out With Him? (created with the help of the creator of Hot Chicks With Douchebags), as well as additional parodies on the douchebag phenomenon.

Kolonick said Cleveland Clinic uses software that flags terms and search words, coupled with a list of Web addresses that are not to be touched. Surfing to a banned site will get you a message reminding employees that Internet use is meant to “facilitate business related information.” A site like TheDirty.com is also unreachable through the Cleveland Clinic system. But employees can get to Barstoolsports.com.

“There is a method behind the madness,” Kolonick said.