CONFIDENTIALITY

CONFIDENTIALITY

CONFIDENTIALITY The promise of NOT to share personal information inappropriately. Grounded in an individual’s right of privacy.  “DO NO HARM”

MEDICAL CONFIDENTIALITY “Whatever, in connection with my professional service, or not in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret.” Hippocratic Oath

“A member of the healthcare team shall respect the principle of medical confidentiality and not disclose without a patient’s consent, information obtained in confidence or in the course of attending to the patient…”

Reasons for maintaining privacy and confidentiality • Fosters trust in healthcare professional-patient relationship • Encourages patients to be honest •  enhances efficacy of medical treatment • Expected by patients • Prevents discrimination based on illness Even the dead may be harmed!

Even the PERCEPTION of lack of privacy and confidentiality can be damaging to the medical profession and healthcare institution.

Confidentiality in modern medicine: access to medical record by many different health care professionals and agencies involved in health care provision  a decrepit concept. Confidentiality in medicine - a decrepit concept. Mark Sigler N Engl J Med 1982; 307:1518-1521

Pitfalls… • Lack of respect • Ignorance • Indiscretion

Confidentiality Breaches of confidentiality can occur through idle gossip by employees in cafeterias and elevators or through the inappropriate use of hospital records. All can create significant legal liability for the hospital and its employees.

Privacy: Common pitfalls … • Inappropriate persons present - lack of assurance of physical privacy, e.g. curtains • Clinics or services dealing with specific medical conditions • Design of waiting areas

Confidentiality: Common pitfalls … (1) • Conversation in public areas • Indiscriminant recycling of documents

Confidentiality: Common pitfalls … (2) • Sharing of information • Details on documents given to third parties

Be alert, and beware… • Social conversations of health care workers • Friends, relatives or colleagues of patients • Employers of patients • Insurance companies • Lawyers engaging in threatened or actual legal proceedings • Communicating with the media • Electronic medical records and computerized data bases • Radio talk shows

Health Insurance Portability and Accountability Act (HIPAA) The first federal legislation to protect patient medical information took effect on April 14, 2002. This legislation limits the way that doctors, hospitals, insurance companies, etc. can use private medical information.

Key provisions of these new standards include: • Access To Medical Records. Patients generally should be able to see and obtain copies of their medical records and request corrections if they identify errors and mistakes.

Key provisions of these new standards include: • Limits on Use of Personal Medical Information.

Key provisions of these new standards include: To promote the best quality care for patients, the rule does not restrict the ability of doctors, nurses and other providers to share information needed to treat their patients.

Key provisions of these new standards include: • Prohibition on Marketing.

Key provisions of these new standards include: • Confidential communications. Under the privacy rule, patients can request that their doctors, health plans and other covered entities take reasonable steps to ensure that their communications with the patient are confidential.

Key provisions of these new standards include: • Complaints. Consumers may file a formal complaint regarding the privacy practices of a covered health plan or provider.

MAINTAIN CONFIDENTIALITY

CONFIDENTIALITY TO TRUST OTHERS WITH PERSONAL & PRIVATE INFORMATION

RESIDENT INFORMATION IS PRIVATE AND PERSONAL

THE RESIDENT’S INFORMATION IS SHARED ONLY AMONG HEALTH CARE TEAM MEMBERS INVOLVEDIN THE PATIENT’S CARE

CENTER AND CO-WORKER INFO IS ALSO CONFIDENTIAL

DO NOT TALK ABOUT RESIDENTS, THE CENTER OR COWORKERS • IN THE ELEVATOR, IN THE HALLWAY, IN THE CAFETERIA, IN THE PARKING LOT OR ANYWHERE OUTSIDE THE CENTER • RESIDENTS & FAMILY MEMBERS THINK YOU ARE TALKING ABOUT THEM

EAVESDROPPING • TO LISTEN IN OR OVERHEAR WHAT OTHERS ARE SAYING • IT IS AN INVASION OF PRIVACY

BE CAREFUL WHAT YOU SAY ON THE INTERCOM

HIPPA

CONFIDENTIALITY • Patient has the right to privacy • Patients entrust in us and we have earned that trust • Especially in small towns as we practice in • No discussion other than those who need to know • Patients will need to disclose private data • Discussion with your instructor is acceptable • Use patient initials on your work and notes • No talking in cafeteria, hallways, elevators

The End

CONFIDENTIALITY