2. CONFIDENTIALITY The promise of NOT to share personal information inappropriately. Grounded in an individual’s right of privacy.  “DO NO HARM” Slide 2

3. 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 Slide 3

4. “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…” Slide 4

5. 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! Slide 5

6. Even the PERCEPTION of lack of privacy and confidentiality can be damaging to the medical profession and healthcare institution. Slide 6

7. 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 Slide 7

8. Pitfalls… Lack of respect Ignorance Indiscretion Slide 8

9. 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. 9

10. 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 Slide 10

11. Confidentiality: Common pitfalls … (1) Conversation in public areas Indiscriminant recycling of documents Slide 11

12. Confidentiality: Common pitfalls … (2) Sharing of information Details on documents given to third parties Slide 12

13. 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 Slide 13

14. 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

15. 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. Slide 15

16. 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. Slide 16

17. Key provisions of these new standards include: Limits on Use of Personal Medical Information. 17

18. 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. 18

19. Key provisions of these new standards include: Prohibition on Marketing. 19

20. 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. Slide 20

21. 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. 21

23. TO TRUST OTHERS WITH PERSONAL & PRIVATE INFORMATION

27. 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 Slide 27

28. EAVESDROPPING TO LISTEN IN OR OVERHEAR WHAT OTHERS ARE SAYING IT IS AN INVASION OF PRIVACY Slide 28

31. 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 Slide 31

32. The End Slide 32