CONFIDENTIALITY

CONFIDENTIALITYThe promise of NOT to share personal

information inappropriately.Grounded in an individual’s right of

privacy.

“DO NO HARM”

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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

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“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…”

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Reasons for maintaining privacy and confidentialityFosters trust in healthcare professional-

patient relationship Encourages patients to be honest enhances efficacy of medical

treatmentExpected by patientsPrevents discrimination based on illness

Even the dead may be harmed!

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

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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 SiglerN Engl J Med 1982; 307:1518-1521

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Pitfalls…Lack of respect

Ignorance

Indiscretion

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ConfidentialityBreaches 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.

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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

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Confidentiality: Common pitfalls … (1)Conversation in public areasIndiscriminant recycling of documents

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Confidentiality: Common pitfalls … (2)Sharing of information

Details on documents given to third parties

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Be alert, and beware…Social conversations of health care workersFriends, relatives or colleagues of patientsEmployers of patientsInsurance companiesLawyers engaging in threatened or actual legal

proceedingsCommunicating with the mediaElectronic medical records and computerized data

basesRadio talk shows

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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. 14

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.

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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.

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Key provisions of these new standards include:

Limits on Use of Personal Medical Information.

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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.

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Key provisions of these new standards include:

Prohibition on Marketing.

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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.

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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.

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MAINTAIN CONFIDENTIALITY

CONFIDENTIALITYTO 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 COWORKERSIN 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

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EAVESDROPPINGTO LISTEN IN OR OVERHEAR WHAT

OTHERS ARE SAYING

IT IS AN INVASION OF PRIVACY

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BE CAREFUL WHAT YOU SAY ON THE INTERCOM

HIPPA

CONFIDENTIALITYPatient has the right to privacyPatients entrust in us and we have earned that

trustEspecially in small towns as we practice inNo discussion other than those who need to

knowPatients will need to disclose private dataDiscussion with your instructor is acceptableUse patient initials on your work and notesNo talking in cafeteria, hallways, elevators

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The End

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