Saudi Commission for Health

Specialties

Professionalism and Ethics Education for

Residents (PEER)

Privacy,
Confidentiality and
Medical Records
Dr. Ghaiath M. A. Hussein

Asst. Prof., Dept. of Medical Ethics

King Fahad Medical City Faculty of Medicine
King Saud Bin Abdul-Aziz University for Health

Outline
Definitions and differences
How to maintain the privacy of our patients?
How to maintain the confidentiality of our patients
information?
When to disclose medical information

Privacy and
? Confidenciality

Confidentiality :
Privacy:

- Is the right of an
individual to have
personal, identifiable
medical information
kept out of reach of
others.

- A right or expectation
to
not be interfered with
- Be free from
surveillance
- A moral right to be left
RESPECTS PATIENTS RESPECTS PATIENTS
alone.
INFORMATION

BODY

PRIVACY

Measures to Protect
Privacy
(KSA guidelines)

1. Make sure examination takes place in isolation from

other patients, unauthorized family members, and/or
staff
2. Provide gender-sensitive waiting and examination
rooms
3. Provide proper clothing for the admitted patients
4. Make sure patients are well covered when transferred
from one place to another in the hospital
5. Make sure your patients body is exposed ONLY as
much as needed by the examination or investigation
6. Patients should have separate lifts and be given priority

Measures to Protect
Privacy
(KSA guidelines)

1. Make sure there is another person (nurse) of the same sex

as the patient present all the time of the examination
2. Always take permission from the patient before examination
3. Insure privacy when taking information from patients
4. Avoid keeping patients for periods more than required by the
procedure.
5. Its prohibited to examine the patient in the corridors or in
the waiting area.
6. During examination, no foreign person unrelated to the
patient allowed
7. Give patients enough time to expose the part with pain
8. Only relevant personnel are allowed to enter the
examination room

CONFIDENTIALITY

Why is there a Duty for

Confidentiality?

Trust between patients and health

professionals.
Patients give information about their
health in confidence.
Individuals will be encouraged to
seek appropriate treatment and
share information relevant to it.

What is Confidential?
All identifiable patient information, whether written,
computerised, visually or audio recorded or simply
held in the memory of health professionals, is
subject to the duty of confidentiality.
It covers:
The individuals past, present or future physical or mental
health or condition,
Any clinical information about an individuals diagnosis or
treatment;
A picture, photograph, video, audiotape or other images of
the patient;
Who the patients doctor is and what clinics patients attend
and when;
Anything else that may be used to identify patients directly
or indirectly

Confidentiality Measures
1. Limit the accessibility to the medical records
2. Do not discuss the patients medical information with
unauthorized family members
3. Do not disclose patients information without his/her
consent, or in established exceptions (below)
4. Do NOT collect information not related to the provision
of care
5. Set policies that regulate access to medical information
and how any breach to confidentiality is managed
6. Limit sharing of information with other staff, unless in
cases of consultations and second opinion

Confidentiality Measures cont.

All records
Never inappropriately access records;
Shut/lock doors, offices and filing cabinets;
Query the status of visitors/strangers;
Advise senior personnel if anything suspicious or worrying is noted;
Manual records
Hold in secure storage;
Tracked if transferred, with a note of their current location within
the filing system;
Returned to the filing system as soon as possible after use;
Stored closed when not in use so that the contents are not seen by
others;
Kept on site unless removal is essential.

Confidentiality Measures cont.

Electronic records
Always log out of any computer system or application when
work is finished;
Do not leave a terminal unattended and logged in;
Do not share Smartcards or passwords with others;
Change passwords at regular intervals to prevent others using
them;
Always clear the screen of a previous patients information
before seeing another.
Email and fax
Whenever possible, clinical details should be separated from
demographic data;
All data transmitted by email should be encrypted;

Proficiency (Medical)
Secret
It includes any information that the doctor (or
treatment team) knows about the patient (alive
or dead), directly or indirectly that a patient may
deem its disclosure undesirable or harmful to
his/her health, reputation, financial, social or
professional status.
It includes any information about the patients
identity, condition, diagnosis, investigations
results, treatment, and/or prognosis (whether
chances of cure, disability, or death)
(Source:
https://sites.google.com/site/ghaiathme/medicaleducation/practitioner-1/practiti
oner
)

Conditions to Disclose Medical

Secret
1. Approval from the patient or his/her SDM, within the
limit given in the approval
2. If the information are required by judiciary
{} { }
3. Consultation or second opinion
4. Notification of events of public health interest/threats
(birth, death, notifiable diseases, etc.)
5. Prevent individual/personal threats (crimes, STIs, ?)
6. If needed by the doctor to defend him/herself before
judges, or discipline committee
7. ? for the doctor to disclose some or all of the secret if
she/he deems this necessary to the cure of the patient!

Have You Ever Witnessed...?

A patient fully exposed in front of a dozen eyes
and pairs of hands (rounds)?
A patient being photographed without consent?
A Couple of doctors chatting about their patients
over lunch?
A doctor, who is a relative of the patient having
a look in his relative's medical record?
A student approaching patients with
questionnaires without consent or institutional
approval?
DONT DO THAT...RESPECT YOUR PATIENTS
PRIVACY & CONFIDENTIALITY

Questions & Discussions

More information on the Medical
ethics Course:
https://sites.google.com/site/medicale
thicscourse/