Dealing with Confidentiality

4.3: Describe the potential tension between maintaining an individual’s confidentiality and disclosing concerns to agreed others.

Disclosing confidential patient information without patient consent can happen in the health care field quite often and is the basis for many cases brought against health care facilities. There are many ways confidential information gets into the wrong hands and this paper explores some of those ways and how that can be prevented.

In the health care business, there are certain standards and laws that have been put in place to protect our patients and their personal health information. When a health care facility fails to protect their patient’s confidential information, the US Government may get involved and facilities may be forced to pay huge sums of money in fines, and risk damaging their reputation.

Seeing information about a healthcare user in such terms makes me realise that some information is not necessarily in the public domain and therefore I have a privilege and responsibility to not only care for the patient but also for the knowledge about them that I am privy to. I realise that, although I have a duty to retain confidentiality, I may be placed in a position where the confidence has to also include other healthcare professionals and I need to involve the patient in such a situation (ibid).

The article, Keep Privacy in Health Records, was written by the Monitor's Editorial Board on February 2, 2009. It condemns some of the provisions of a House Bill that was passed by the ACLU and other privacy groups. According to this bill, data encryption would ensure that authorized persons are barred from accessing patient’s health records in the institution. Audit trails are also crucial in determining and tracking who accessed the records, at what time and what type of information did he/she get. Lastly, the patients should be allowed to see their records to improve their notification and strengthen enforcement in health institutions. However, despite these initiatives to improve accountability and confidentiality of patient’s records in most institutions, the board believes that the bill has not solved some of the privacy issues as far as patient health records are concerned.

Recent developments in technology have changed the delivery of health care and the system used to record and retrieve health information. In addition to using paper medical records, healthcare professionals, hospitals and insurers routinely use computers, phones, faxes, and other methods or recording and transferring information. In many instances, this information - which could include medical diagnoses, prescriptions, or insurance information - is readily available to anyone (including clerical and other staff) who walks by a fax machine or logs on to a computer. This lack of privacy has the potential to undermine patients' relationships with providers and adversely affect the quality of care. Patients may also fear that the exposure of personal health information, including the results of genetic tests that are becoming increasing available, could result in the loss or denial of health insurance, job discrimination or personal embarrassment.

This article has shown how different issues relating to patient privacy can be tricky. There is always the question about what the right thing is to do but there are laws and regulations

The privacy portion of the Health Insurance Portability and Accountability Act of 1996 is a substantial portion of the law that has indeed gained the most attention and had the widest impacts – more so even than the insurance portability portion. The rules that make up the privacy piece of the law are intended to protect patients from having information about their medical history and medical care released to anyone that doesn’t have a right to know. The Security Rule supports the Privacy Rule in how it affects technological advances in healthcare – specifically, electronic medical records: Electronic Medical Records or Electronic Health Records (EMR’s or EHR’s, respectively). The Breach Notification Rule supports patients’ privacy not only by mandating reporting to

In today’s health care industry providing quality patient care and avoiding harm are the foundations of ethical practices. However, many health care professionals are not meeting the guidelines or expectations of the American College of Healthcare Executives (ACHE) or obeying the organizations code of ethics policies, especially with the use of electronic medical records (EMR). Many patients fear that their personal health information (PHI) will be disclosed by hackers or unauthorized users. According to Carel (2010) “ethical concerns shroud the

Everyone is entitled to confidentiality unless they give permission for someone else to see their information or they can no longer make decisions on their own (for example, if they are confused or comatose). A federal law, Health Insurance Portability and Accountability Act applies to most health care physicians and its guideline, known as the Privacy Rule. The Privacy Rule sets specific rules regarding privacy, access, and disclosure of information. For example, HIPAA specifies the following:

In this paper, I will discuss the principles that permit disclosure of protected health information with or without the patient’s consent for each of the four categories, government agencies, legal agencies or representatives and research groups. I will also state whether I feel privacy safeguards are adequate to support those principles.

In a world full of electronics it would only seem logical to have health records electronic. Not only are medical records efficient, reliable, and quick to access, new technology allow patients to access their own personal medical records with a simple to use login and password. “People are asking whether any kind of electronic records can be made safe. If one is looking for a 100% privacy guarantee, the answer is no”(Thede, 2010). At my hospital, upon every admission we ask the patient for a password for friends and family to have to have if they would like an update on the patient 's condition. We do not let visitors come up and see the patient without the patient 's consent. In doing these things, we help to ensure the safety and protection of the patient 's health information and privacy.

Privacy and confidentiality are basic rights in our society. Safeguarding those rights, with respect to an individual’s personal health information, is our ethical and legal obligation as health care providers. Doing so in today’s health care environment is increasingly challenging (OJIN, 2005).

The first principle is that with very few exceptions, health care information about a consumer should be disclosed for health purposes only. The information should be easy to use for those purposes, and very difficult to use otherwise. The second principle is that technical security safeguards be maintained for computerized data. Including audit trails that identify who accessed the data and the prosecution against anyone who used the records for illegal or improper purposes. The third principle is consumer access. The patient should have ability to access his or her records and know others that also have access to them. Patients should be aware of the laws, regulations, and policies that protect their information. The fourth policy is defined as accountability, which is of relation to security and consumer control. Fines and imprisonment are required to those who breach security of personal health information. The final policy is public responsibility. Legislation must be balanced between personal, private interests and national priorities of public health, research, and law enforcement. The excessive flow of information, without patient authorization, is essential to the immediate discovery and investigation in public health crisis. AHIMA's acknowledgement of these five principles are abroad outline of a sensible public policy that balances personal privacy

In light of available security measures and their widespread acceptance within the information security community, there is no excuse for healthcare organizations to fail in fulfilling their duty to protect personal patient information. Guaranteeing the confidentiality and privacy of data in healthcare information is crucial in safeguarding the data of patients as there should be a legal responsibility to protect medical records from unauthorized access.