Daisha Estrada is in the clinic today. While you are escorting another patient, an 85-year-old woman, out to the waiting room, you and the patient overhear the lab tech and another nurse talking about Daisha’s lab results. They are discussing her vaginal smear coming back positive for gonorrhea. As you are escorting the elderly woman out to the waiting room she asks if gonorrhea is contagious. “Those two ladies in the hall were talking about having to report that woman’s lab result to the CDC. Wouldn’t you only be contacting the CDC if it were serious…can I get it from being here today?”
Imagine you are working at a hospital. You find out that one of your friends was admitted to the hospital last night and has had surgery. Although you are not assigned to take care of your friend, she is in the unit that you work, therefore you have access to her medical record. You are in the EHR documenting on your assigned patients and decide to take a “quick look” at your friend’s chart to find out why she had surgery and how she is doing. A little later you call a family member to tell them about your friend’s surgery.
Protecting patient privacy and maintaining confidentiality are fundamental principles in healthcare. However, instances of breaches in privacy and confidentiality can occur, compromising patients’ trust and potentially causing harm. This essay addresses two scenarios that involve privacy violations and explores the ethical implications and consequences of such actions. Additionally, it discusses the importance of current regulations in reducing inappropriate access by authorized users and provides an example of how these regulations can mitigate this problem.
In the first scenario, healthcare workers in the clinic openly discuss a patient’s lab results, including a positive gonorrhea diagnosis, within earshot of other patients. This breach of privacy violates the patient’s right to confidentiality and undermines their trust in healthcare professionals.
The Privacy Rule, as outlined by the Health Insurance Portability and Accountability Act (HIPAA), governs the protection of patients’ individually identifiable health information. Reporting certain diseases and illnesses to the Centers for Disease Control and Prevention (CDC) serves a public health purpose. The Privacy Rule permits covered entities, such as healthcare providers, to disclose protected health information to public health authorities, like the CDC, for disease surveillance and control (U.S. Department of Health and Human Services, 2013). However, specific safeguards must be in place to ensure patient privacy.
In the scenario, the healthcare workers breached the patient’s confidentiality by discussing her lab results publicly. This violates the patient’s right to privacy and compromises her dignity. Furthermore, their conversation could potentially lead to stigmatization and harm to the patient’s reputation.
Healthcare workers should have respected the patient’s confidentiality by discussing sensitive information in a private and secure setting. They could have utilized designated areas, such as private offices or meeting rooms, to ensure privacy and prevent inadvertent disclosure. Implementing effective communication protocols, such as discussing patient-related matters behind closed doors or using secure communication channels, would uphold patient privacy and foster a culture of confidentiality.
Under Federal Law, the Privacy Rule safeguards individually identifiable health information, including demographic data, medical history, laboratory results, and any other information linked to a patient’s identity. This includes all electronic, written, or oral forms of health information (U.S. Department of Health and Human Services, 2013).
In the second scenario, a healthcare worker accesses a friend’s medical record without a legitimate need and later divulges the information to a family member.
The healthcare worker violated patient privacy and confidentiality by inappropriately accessing a friend’s medical record. This breach of trust and confidentiality can have severe consequences, including legal ramifications, damage to professional reputation, strained personal relationships, and potential harm to the patient.
Current regulations, such as the HIPAA Privacy Rule, are designed to address inappropriate access to patient information. These regulations outline strict protocols regarding authorized access to patient records, including the principle of least privilege, which grants access only to information necessary for an individual’s job responsibilities. Healthcare organizations are required to implement technical and administrative safeguards, such as user authentication and auditing systems, to monitor and track access to patient records (U.S. Department of Health and Human Services, 2013).
The regulations in place help reduce or eliminate inappropriate access by authorized users through several mechanisms. Examples include:
User Authentication: Implementing secure user authentication processes, such as unique usernames and passwords, restricts access to authorized personnel only. This helps prevent unauthorized individuals from accessing patient records.
Audit Trails: Utilizing audit trail systems allows healthcare organizations to track and monitor access to patient records. By logging access activities, organizations can identify potential breaches and take appropriate action.
Privacy and confidentiality are critical components of healthcare practice. Violations of patient privacy not only breach legal and ethical obligations but also erode trust in the healthcare system. The scenarios discussed highlight the importance of upholding patient privacy and the potential consequences of failing to do so. Current regulations, such as the HIPAA Privacy Rule, provide a framework to protect patient information and mitigate inappropriate access, promoting trust and maintaining the integrity of healthcare practice.
U.S. Department of Health and Human Services. (2013). Summary of the HIPAA Privacy Rule. Retrieved from https://www.hhs.gov/hipaa/for-professionals/privacy/laws-regulations/index.html
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