Purtilo & Doherty (2011) Chapter 10 Why Honor Confidentiality? Slides by W. Rose and C. Polek College of Health Sciences University of Delaware

College of Health Sciences Chapter 10 I.Introduction II.The Goal: A Caring Response III.Six Step Process in Confidentiality Situations IV.Confidentiality, Records, and Patient Care Information Systems V.Examples

College of Health Sciences Chapter 10 I.Introduction Cast: Twyla Roberts, O.T. who delivers care in patients’ homes. Mary Louis, Twyla’s patient, recovering at home after a hospital stay.

College of Health Sciences Chapter 10 I.Introduction II.The Goal: A Caring Response A.Identifying Confidential Information 1.Confidential information = info about a patient that is harmful [to whom?], shameful, or embarrassing 2.Who decides? 3.Err on the side of caution B.Confidentiality and Privacy 1.Notion of confidential information related to “right to privacy”, but with a twistright to privacy 2.Exercise: Report what the code of ethics or code of conduct for the health care profession of your choice says about confidentiality.

College of Health Sciences II.The Goal: A Caring Response A.Identifying Confidential Information B.Confidentiality and Privacy C.Confidentiality, Secrets, and the “Need to Know” 1.Keeping Confidences a.Need to know info = info necessary to adequately perform one’s specific job responsibilities b.If another professional has a need to know, it is not a breach to share that info c.Maintaining confidentiality is a means to the ends of building trust and maintaining patient dignity 2.Breaking Confidences 1.Sometimes required for the most caring response 2.See list of acceptable reasons, P&D p Does benefit of breaking confidence outweigh harm of damage to trust? 4.How can the harm be minimized?

College of Health Sciences I.Introduction II.The Goal: A Caring Response III.The Six Step Process in Confidentiality Situations A.Gather Relevant Info B.Identify the Type of Ethical Problem What kind of problem? C.Use Ethical Theories or Approaches to Analyze It 1.Principles? 2.Character traits? D.Explore Practical Alternatives Name some. E.Act F.Evaluate the Process & Outcome

College of Health Sciences I.Introduction II.The Goal: A Caring Response III.Six Step Process in Confidentiality Situations IV.Confidentiality, Records, and Patient Care Information Systems A.The Medical Record 1.Paper & electronic 2.Many authors B.HIPAA (1996) 1.Goal: Protect individual health information while allowing information flow needed to promote high quality care 2.Control use & disclosure of “protected health information” C.HITECH (2009) 1.Expands & strengthens HIPAA 2.Requires adoption of EHRs by providers

College of Health Sciences Chapter 10 I.Introduction II.The Goal: A Caring Response III.Six Step Process in Confidentiality Situations IV.Confidentiality, Records, and Patient Care Information Systems V.Examples