This means that doctors may discuss a diagnosis with colleagues if the disclosure is necessary for treatment. For centuries, doctors have upheld this ethical principle underpinned by the Hippocratic Oath that has been updated by the international community assenting to the Declaration of Geneva. Identify and explain two exceptions to confidentiality in healthcare settings. Disposing on paper PHI starts with shredding. According to the American Academy of Family Physicians (AAFP), there are four exceptions to patient confidentiality. If you think your doctor or other provider is mishandling your information, your first step is to ask them about it. Health care professionals are generally obliged by confidentiality clause in their contract of employment as well. First, a medical-care provider can disclose PHI to another physician. As a result, each NHS Trust has a nominated Caldicott Guardian responsible for protecting patient confidentiality by ensuring the Caldicott principles are followed when breaching confidentiality. The other two General Rule exceptions can also be problematic for Covered Entities because, although a State law may permit certain disclosures of PHI to state and federal agencies, the information provided to state and federal agencies can be accessed via Freedom of Information requests. The local HIV team should preferably be involved in such circumstances. Patient confidentiality is necessary for building trust between patients and medical professionals. Ideally, it is important for doctors to maintain professional integrity by making efforts to gain express consent where applicable. That coworker could reveal to colleagues that youre seeking help from a behavioral health professional. The NHS has historically had a poor record of data protection. Confidentiality of minor health care services . Anyone who works in the healthcare industry knows that they should avoid HIPAA violations at all costs. The three general principles underlying disclosures are those with patient consent, those regarding a statutory obligation, and those for which the public interest outweighs the preservation of confidence. Healthcare providers physicians, nurses, medical institutions, and others who deal with patient health information are known as covered entities. Do you remember earlier when I mentioned waiting room design? nutrition services, such as dietitians and nutritionists, allied health services, such as optometrists and physiotherapists, naturopaths, chiropractors, massage therapists and other complementary medicine providers, fitness providers, such as gyms, fitness trainers and weight loss services. Confidentiality is central to the preservation of trust between doctors and their patients. Unfortunately, if these files arent disposed of securely, the sensitive information could fall into the hands of malicious individuals. According to the HHS, the HIPAA Privacy Rule recognizes that sometimes public health authorities and others responsible for ensuring public health and safety need to access PHI. The Medical Reports Act 1988 permits individuals access to personal medical reports for employment or insurance purposes. His work primarily appears on various websites. Despite all of this, though, a breach of patient confidentiality occurs every 62.5 hours. The Data Protection Act has outlined the principles (Table2), but several incidences of public authorities losing personal data show how poor information governance can be.5 Significant financial penalties have been imposed by the Information Commissioner for such breaches, and as such, systems must be in place to secure personal data within the healthcare setting. The Caldicott principles for storage and use of personal information, Only use patient-identifiable information where absolutely necessary, Use the minimum necessary patient identifiable information, Access to personal information should be on a strict need-to-know basis, All users and handlers of patient-identifiable data should be aware of their responsibilities. Oxford University Press is a department of the University of Oxford. Nobody gets to share your healthcare information without your permission. Any other covered entity within the same organized healthcare arrangement for any healthcare operations arrangement. Coroners are entitled to request medical details relevant and necessary to their enquires; therefore, pertinent clinical information must be disclosed upon request. On a larger scale, when the medical community is trusted, the public is more willing to participate in research studies and healthcare campaigns that can prevent the spread of certain illnesses. Be sure to review them on your licensing boards website and stay current on the literature relevant to their implementation in your jurisdiction. These are: There are certain exemptions that may apply in law enforcement situations and in a court of law. Exceptions to Informed Consent Several exceptions to the requirement for informed consent include (1) the patient is incapacitated, (2) life-threatening emergencies with inadequate time to obtain consent, and (3) voluntary waived consent. These mandatory reporting laws include: Child abuse reporting Elder/vulnerable adult abuse reporting Infectious disease reporting Injury reporting Duty to warn if a patient is threatening themselves or others As a patient, you might feel embarrassed or ashamed to have your health conditions shared with others. Data controllers, including NHS organizations, are required to comply with the eight data protection principles as summarized in Table1. The reality is that its hard to maintain patient privacy. The duty to warn/protect: Issues in clinical practice. You control what goes into your eHealth record, and who is allowed to access it. Duty to warn and protect: Not in Texas. Furthermore, when the need to know basis is exceeded, disciplinary proceedings may arise (Duncan v Medical Practitioners Disciplinary Committee [1986] 1 NZLR 513) or patients may seek damages for inappropriate breaches (Cornelius v Taranto [2001] 68 BMLR 62). Any healthcare professionals who you see are bound by these rules. They should not be used to replace the advice of legal counsel. View all blog posts under Articles | View all blog posts under Bachelors in Healthcare Practice Management. In a critical care setting, it may seem unreasonable to refuse to provide information to a next-of-kin when a patient is seriously ill as this may be in the patient's overall best interests. This justification is more subjective and in contentious cases, the courts may be required to decide. -be in the public interest to protect it. Policies can include granting access to protected health information to healthcare organization members if it helps them carry out their dutiesmore effectively, in the best interest of patient outcomes. If a serious communicable disease has contributed to a patient's death, this must be recorded on the death certificate.11 Information relating to serious communicable disease should be passed on to the relevant authorities, while preferably maintaining anonymity to improve control and maintain surveillance. (2006, December). The RCoA/AAGBI Joint Informatics Committee recommends recording the patient's hospital number and age to enable verification by educational supervisors while arguably providing sufficient data protection. It also serves the physicians best interests. Interestingly, some jurisdictions have a duty to warn statute, some have a duty to report statute, some have a duty to warn and protect statute, others may have duty to warn, protect, or treat statutes, and some may have none of the above. Disclosures should always be limited to reveal only the relevant and appropriate information.3. Together with the Office of the National Coordinator for Health Information Technology (ONC), HHS offers aSecurity Risk Assessment Tool that helps guide healthcare practitioners through the risk assessment process. Health care professionals in the United States would be authorized to disclose health information of persons infected with H1N1 to public health authorities to control the disease. Two other pieces of legislation provide additional guidance but interpretation varies. When you go to hospital, you can choose to give the staff access to your health records. Examples of Exceptions to Patient Confidentiality. Patients are more likely to disclose health information if they trust their healthcare practitioners. How does no one realize it? Copyright 2023 Leaf Group Ltd. / Leaf Group Media, All Rights Reserved. Now imagine that the person who broke your trust was a doctor and that the information they shared was your diagnosis! This requires the recording of patient identifying details. The HIPAA Privacy Rule, therefore, does not protect a persons health information when the person has a communicable disease or if the persons health must be disclosed for public safety reasons. 10). A duty of confidence arises when one person discloses information to another (e.g. 13). Including as little identifying information as possible on a patient voicemail decreases further decreases the risks associated with patient confidentiality. Patient confidentiality is not absolute. One of the best ways to protect patient confidentiality is through training. This applies when caring for patients, communicating with colleagues, and maintaining records. This means that the health professional will first attempt to address this threat through treatment such as through civil commitment or other forms of treatment that prevent the intended harm from occurring (and thus alleviating the need to warn and protect). If you are concerned about the laws in your jurisdiction become an active advocate in the legislative process such as through involvement in the American Psychological Associations Practice Directorate and your State, Provincial, or Territorial Psychological Association. The circumstances permitting deliberate disclosures will now be discussed further. 1. Be obtained only for one or more specified and lawful purposes, Be adequate, relevant, and not excessive in relation to the purpose or purposes for which they are processed, Be accurate and, where necessary, kept up-to-date, Be processed in accordance with the rights of data subjects, Have appropriate technical and organizational measures taken to prevent unauthorized or unlawful processing of personal data and against accidental loss or destruction of, or damage to, personal data, Not be transferred to a country or territory outside of the European Economic Area unless that country or territory has adequate protection for the rights and freedoms of the data subjects in relation to processing of personal data, Health professionals must be vigilant to the potential risks of inadvertent breaches when using social networking sites such as Facebook, Internet forums, and blogs to communicate either personally or professionally.