Posts tagged confidentiality

Recorded

  • Me: Is there anything else that is bothering you?
  • Patient: I have been recording some conversations.
  • Me: ...And you understand that that is not legal?
  • Patient: ...Yes.
  • Me: ...Alright.
Photos & Videos Prohibited.
Following last week’s post about digital confidentiality over the phone, today I would like to spend some time talking about the state of photo and video sharing.
In this day and age, sharing photos and videos has become easy and instantaneous, from the likes of Instagram to medically oriented applications like Figure 1.
However, in the medical field, confidentiality is still the bottom line. A photo or video shared to your friends of an interesting finding without the expressed consent of the patient, despite taking care to make sure the patient is not identifiable in the picture, is still a breech in confidentiality. Patients are humans, not specimens, and have a right to their own bodies.
But I need it for a case presentation. What do I do?
Typically, photos and videos are taken for a reason, such as research, academic, or educational purposes. The limits should be explained to a patient, particularly what you would like to use, how you will use it, and who will be seeing it. Furthermore, remember to explain that non-contributory information will remain private and anonymized to protect their identity. If all of this goes well as the saying goes, “Document it!” Make a note in the chart, and print an information release form for them to sign to make it official.
In the instances where I have taken photographs of patient findings, it was for use in case study presentations, and all of the above procedures must have their blessing. It is tedious work and perhaps rightly so. As it becomes easier to share, we tread on thinner ice.
Next pearl: Case Study…Previous pearl: Digital Confidentiality…

Photos & Videos Prohibited.

Following last week’s post about digital confidentiality over the phone, today I would like to spend some time talking about the state of photo and video sharing.

In this day and age, sharing photos and videos has become easy and instantaneous, from the likes of Instagram to medically oriented applications like Figure 1.

However, in the medical field, confidentiality is still the bottom line. A photo or video shared to your friends of an interesting finding without the expressed consent of the patient, despite taking care to make sure the patient is not identifiable in the picture, is still a breech in confidentiality. Patients are humans, not specimens, and have a right to their own bodies.

But I need it for a case presentation. What do I do?

Typically, photos and videos are taken for a reason, such as research, academic, or educational purposes. The limits should be explained to a patient, particularly what you would like to use, how you will use it, and who will be seeing it. Furthermore, remember to explain that non-contributory information will remain private and anonymized to protect their identity. If all of this goes well as the saying goes, “Document it!” Make a note in the chart, and print an information release form for them to sign to make it official.

In the instances where I have taken photographs of patient findings, it was for use in case study presentations, and all of the above procedures must have their blessing. It is tedious work and perhaps rightly so. As it becomes easier to share, we tread on thinner ice.

Next pearl: Case Study…
Previous pearl: Digital Confidentiality…

Please Remember Patient Confidentiality.
As a medical student who sees patients through many specialties, I often find myself in situations where a distant conversation catches my ear. Because I identify.
I identify who is being referred…
"This patient of mine is not doing so well. Developed a pulmonary embolism following…"
..or did I? I listen longer. Perhaps I was wrong.
We do our best always to keep the confidence of our information. We find quiet, private areas. We discuss them in hushed voices, hidden from public scrutiny. We remove as many identifiers as is feasible to convey our intentions. 
Yet we still let slip on occasion. We are human after all. This sign is a testament to that. It is a reminder that we must all be mindful of our words.
You never know who is listening.

Please Remember Patient Confidentiality.

As a medical student who sees patients through many specialties, I often find myself in situations where a distant conversation catches my ear. Because I identify.

I identify who is being referred…

"This patient of mine is not doing so well. Developed a pulmonary embolism following…"

..or did I? I listen longer. Perhaps I was wrong.

We do our best always to keep the confidence of our information. We find quiet, private areas. We discuss them in hushed voices, hidden from public scrutiny. We remove as many identifiers as is feasible to convey our intentions. 

Yet we still let slip on occasion. We are human after all. This sign is a testament to that. It is a reminder that we must all be mindful of our words.

You never know who is listening.

Digital Smarts - A Common Sense Primer for Interns from Bryan Vartabedian MD and Joey Spinner MD

This is a short video on being smart about our own digital footprints within the healthcare setting. The risks and challenges of social media is one that I am constantly trying to manage. While I have many checks and balances in place for myself, I am always on edge about what goes up on this blog.

Let this video be another reminder to be ever vigilant.

On the Anonymity of Medical Professionals

Dr. Cranquis answered a question today about medical anonymity in the digital world and I think it is worth revisiting. With information so easily accessible nowadays, it would be foolish to take the situation lightly. There is constantly a risk I run of stepping on somebody’s toes and sullying whatever credentials I have. These are marks against me that might carry on throughout my studies and beyond. 

In the digital age, doctors like Dr. Cranquis and other medical students I know who have taken to the internet are very much so breaking new ground into uncharted territory. Though Dr. Parkinson says in his recent TEDx talk that no negative consequences have come to bear on anyone, I am not going to take risks that might put me out in the open.

When I started this blog in late July of 2010, I came into it not realizing how sensitive and how difficult it might be to blog about medicine. There are many areas that simply are too sensitive to discuss in any detail. This sensitivity, compounded by the fact that my name, face, and area of study are readily identifiable in the public domain, means anything I write could risk breaching patient confidentiality and be a personal liability. Every day, I tread carefully.

Every time I write, I must always ask myself: how much detail is too much? what can I write about without putting myself, the patients I see, and the medical profession at risk? Sometimes, it is easy to de-identify patients or change the details of the story to preserve the essence of the event; other times, it is not so easy, and that has meant I have avoided writing about many amazing moments in my journey. I am sure many more will follow in the long road ahead. That is the price I pay for not being anonymous. 

There was once a social contract between the public and doctors that we would govern ourselves, safeguard our own profession, and the patients that fall under our care; it exists to this day. Online, the onus is on ourselves to protect that principle.

Leave a comment below about your thoughts on the topic.

Where do you think your learning scenarios come from? They all had some sort of real-life basis. Do you think the patients had consented to have their information made public in such a way? Everyone tells someone about what they have seen. God knows what you students have been telling your friends about med school!
Guest lecturer during an ethics lecture on patient confidentiality.