The Impact of Technologically Facilitated Multi-agency Care on Patient Privacy
In the golden age, which probably never existed, your information was safe with your personal physician. Not least because it was recorded on a paper form which was filed away in a locked filing cabinet and never looked at again.
Computers allow us to retrieve and share information much more easily, for better or for worse. Increasingly, patient care is becoming a multi-agency activity, involving several health agencies, social care agencies and, increasingly, voluntary agencies. This requires us to address the distinction between legitimate information sharing and a privacy breach.
There is a tension between providing the best possible information, especially in a multi-agency situation to facilitate the best possible care and the need to respect confidentiality and the need for privacy
In the U.K, the Data Protection Act 1998, medical purposes include but are wider than healthcare purposes. They include preventative medicine, medical research, financial audit and management of healthcare services. The Health and Social Care Act or 2001 explicitly broadened the definition to include social care.
Experience shows that there are different attitudes to information collecting.
In the U.K. healthcare sector, generally there is a view that the more information collected the better, since this provides a richer picture of the health of the patient. Particularly in primary care, a wide range of factors may influence the health of the patient, and the immediate symptoms and stated reason for consulting the doctor may not be the most significant factors. This has sometimes had a negative influence on GP information systems, which have tended to become 'sinks' for information, with little thought as to when the information may be retrieved and in what form.
By contrast, social workers tend to be much more minimalist in their information collection, preferring to emphasise that only relevant and targeted information, which is linked to specific courses of action, is collected. This has been explained in terms of the fear of litigation. This derives from cases where following a failure of care, it can be shown that information was available and not acted on.
Health care workers may find social care agencies less than grateful for a drip feed of inconclusive pieces of information relating to problems with children at risk or mental health patients housed in the community.
System usage must therefore be defined within agreed protocols, where it is clearly defined at what point action is required on the part of an individual professional or manager. However, it is recognised that even this may not be enough to 'sell' the system if a culture of fear exists.