Study Set Content:
…protecting privacy and confidentiality benefits both
individuals and society
…privacy and confidentiality protections also benefit
public health
physicians should hold health care information in () is therefore applicable whether the data are written on paper, etched in stone, or embedded in silicon
confidence
The obligations to () privacy and to keep confidences fall to system designers and maintainers, to administrators, and, ultimately, to the physicians, nurses, and other people who elicit the information in the first place
protect
…protection of privacy and confidentiality is not an option, a favor, or a helping hand offered to patients with embarrassing health care problems; it is a()that does not vary with the malady or the data-storage medium
duty
…sound clinical practice and public-health traditions run counter to the idea of absolute
confidentiality
When a patient is hospitalized, it is expected that all appropriate (and no inappropriate) employees of the institution—primary-care physicians, consultants, nurses, therapists, and technicians—will be given() to the patient’s medical records, when it is in the interest of patient care to do so
access
Patients with active tuberculosis and STI’s and their contacts are identified; the public is protected, decrease transmission of
infection
important for clinicians to be able to get timely and accurate patient da
➢ Access to electronic patient records
Institutions not using computer-based patient records are falling
behind
Failure to prevent inappropriate access is at least as wrong as failure to provide adequate and
appropriate access
maintain a standard of care while ensuring that the standard does not imperil the
rights of the patient
economic abuses, or discrimination by third-party payers, employers and others who take advantage of the burgeoning market in health data; insider abuse, or record snooping by hospital or clinic workers who are not directly involved in a patient’s care but examine a record out of curiosity, for blackmail, and so on; and malevolent hackers, or people who, via networks or other means, copy, delete, or alter confidential information 30 Threats to confidentiality and privacy
National Research Council, 1997
can provide the means for maximizing their own security, including authenticating users, by making sure that users are who they say they are; prohibiting people without a professional need from accessing health information; and using audit trails, or logs, of people who do inspect confidential records so that patients and other people can review the logs.
Computers
has recommended that hospitals and other health care organizations create security and confidentiality committees and establish education and training programs
The National Research Council
In clinical research, use of patient information is a () especially if they are the subjects of the research
must
makes it easier for researchers to identify the potential subjects for their research
Electronic patient record
. Use specific and unique patient identifiers to protect
confidentiality
Anonymize the information in
individual records
• A specific job description (“this 30- year-old starting quarterback of the Wildcats professional football team was admitted with a shattered collarbone”), or a rare disease diagnosis coupled with demographic data, or a nine-digit postal code may act as a
surrogate unique identifier
