Causes and Consequences of Breach of Confidentiality of Patient Health Information in Lagos University Teaching Hospital, Lagos State
CHAPTER ONE
AIMS AND OBJECTIVES OF THE STUDY.
BOARD OBJECTIVE
To assess the causes and consequences of breach of confidentality of patient health information in Lagos University Teaching Hospital, Lagos state.
THE SPECIFIC OBJECTIVES INCLUDE:
- To assess the impact of the level of knowledge and the awareness of healthcare workers on breach of confidentiality of patient information.
- To identify the factors that causes breach of confidentiality of patient information among healthcare workers in Lagos university teaching hospital (LUTH).
- To know if availability of adequate space have impact on maintenance of confidentiality of health information.
- To find out the solutions to tackle the occurrence of breach of confidentiality of patient information among healthcare workers in Lagos University Teaching Hospital (LUTH).
- To assess the impact of breach of confidentiality on the relationship between the patients and the healthcare professionals.
CHAPTER TWO
LITERATURE REVIEW
Health information is the clear concise and accurate history of a patient’s life and illness written from the medical point of view. It is a collection of recorded facts concerning a particular patient and also it is a device used for recording the significant characteristics of a particular patient and his/her illness and the events occurring in the course of professional care for the purpose of providing the best medical care to the patient, for teaching, research and study appraisal of medical practice and legal requirements. The quality of health care depends on proper management of patient health information, therefore efficient health care delivery system rest on a good system of health information storage and preservation (Benjamin 2010) Confidentiality is one of the core duties of medical practice. It requires health care providers to keep a patient’s personal health information private unless consent to release the information is provided by the patient.
Patients share personal information with health workers. Health care providers have a duty as professionals to respect the patient’s trust and keep this information private. This requires the health workers to respect the patient’s privacy by restricting access of others to that information, furthermore, creating a trusting environment by respecting patient privacy and encourage the patient to be as honest as possible during the course of the visit.(Journal General Internal Medicine,2012)
When considering sensitive health information requiring special layers of confidentiality, such as with mental health treatment, state statutes provide guidance for health information management professionals. In Illinois, for example, the Mental Health and Developmental Disabilities Confidentiality Act offers detailed requirements for access, use and disclosure of confidential patient information including for legal proceedings (MHDDCA, 2007).
CONFIDENTIALITY OF MEDICAL INFORMATION
Osundina (2005) asserts that information in medical records is confidential because it contains secret information relating to the well-being of a particular patient and it is held that the relationship between patient and physician is special and that their communication should be protected from disclosure. This is supported in the physician’s code of ethics and ethics guiding health information management profession and in the law court; therefore, the protection of the bond of confidence between the patient and the healthcare professionals is extremely important to the success of that care. The importance of confidentiality is underwritten by the law and the penalties entails by a breach can be very severe. If a patient feels that he has been damaged by the disclosure of information he can sue the hospital authority and could join in the action any member of staff who he feels is part of the people (circle) bound by the confidence. This is justified because the society feels that patient’s information in the hospital ought to be secured.
OWNERSHIP OF PATIENT HEALTH INFORMATION
Ownership carries with it the power of dominion and control, but this type of ownership does not extend to medical records because of the confidential information and the responsibility of the health care providers on patients in the course of treatment. Therefore, ownership of patient records is vested in the government or the hospital; the hospital should not release or divulge patient medical information without the authority or permission of the patient, and otherwise it may lead to court case. A patient wishing to see his health information should be requested to consult his doctor or procure a written authorization from his doctor. If the hospital allows the patient or his representatives to see his/her records, few conflicts will appear due to misinterpretation of the medical terminology used in documenting the records and legal questions are raised.(Solomon, 2006) In Nigeria, the hospital owns patients’ records, according to the Public Service Rules (2011) (Chapter 7, section 1 rule 2. (070102) which states that patients’ record, medical certificates and medical documents are to be treated as confidential in both government and private hospitals and no copies should be furnished except the rules guiding the release of patient information are applied. Health records are maintained precisely because the information it contains is of the highest value to the individuals and organization having a legitimate need to know its contents. The majority of requests come from third party payment plans such as blue cross legal representatives, medical care agencies, and commercial insurance companies. Moreover patients and their relatives, the members of the medical staff, other physicians and hospitals concerned with the care of patients, governments and other agencies also request information. Sound rules and good public relationship are the important consideration in the developments of policies governing the release of information. Hospital receives many legitimate inquiries from welfare organizations, court insurance cases, and other organizations. Such inquiries are for the benefits of patients and the release of information without written authorization of the patient would not meet with criticism; but for the protection of patients therefore the health information director should always require proper authorization from the patient for release of information. (Osundina 2005)
CHAPTER THREE
RESEARCH METHODOLOGY
This chapter discussed the methods and procedure used in the study. The area discussed include, research design, research instrument, validity of instrumentation, target population, sample and sampling techniques, method of data collection procedure, instrument and method of data analyses.
RESEARCH DESIGN
The research method adopted is descriptive survey. This descriptive research work deals with investigation into the effectiveness of confidentiality of patients’ health information in the hospital.
CHAPTER FOUR
DATA PRESENTATION AND DISCUSSION OF FINDINGS
This chapter presents the analysis and interpretation of data generated in the course of data collection.. The chapter is presented in three parts which are analysis of respondents’ socio demographic characteristics, followed by analysis of research question while the last part presents the discussion of the findings. One hundred and nineteen questionnaires was administered and was recovered.
CHAPTER FIVE
SUMMARY, CONCLUSION, RECOMMENDATION AND LIMITAION
Summary
This study employed descriptive design to examine the assess the level of breach of confidentiality of patient health information among health care professionals in Lagos University Teaching Hospital, Lagos state. Five objectives were developed for the study in accordance. Structured questionnaire was the major data collection procedure and Stratified Random Sampling technique was adopted. The whole population was divided into strata (homogenous subgroup) in accordance with their profession; the instrument was developed through extensive literature search.
Data collected were presented using frequency table and simple percentage. In the course of this research 100 questionnaire were retrieved out of 119 given to the respondents.
The study found out that majority of the respondents strongly agreed that the level of knowledge of healthcare professionals is paramount to the confidentiality of patient health information and in reduction of breaches of the information. Further factors were measures to reduce breaches of confidentiality among healthcare practitioners such as introduction of effective filing system, mutual Communication between patient and care giver and also training of medical practitioners on patient information confidentiality and impact on the hospital.
Conclusion
The study concluded that most breaches of confidentiality among healthcare professionals in the hospital is because of their level of knowledge of impact of breach of confidentiality of the patient care because some hospital makes use of non qualified professionals. In the case of litigation of court cases, hospital will not achieve much as public will lost confidence on the healthcare professionals in the hospital. On the contrary, it increases the risks of hospital poor revenue, and patient not giving adequate information necessary for their proper treatment.
Recommendations.
Based on the research findings, the following recommendations were suggested as Measures to reduce the incidence of breaches of confidentiality of patient health information among healthcare professionals in the study area:
- Provision of adequate education and training about the consequences of breaches of confidentiality of patient health information.
- Mutual communication between patients and care giver
- Flexibility in the process of Health Researches.
- Implementation of electronic health records
- Provision of adequate space for storage
- Training of medical practitioner on patient counseling.
- Provision of punishment to any healthcare professional that breach confidentiality of the patient health information.
- Prioritization of patient information
Limitation of the study.
The study was challenged and thus limited by the following constraints: Time, Finance, and
Restrictions to reach out to the respondent due to their busy schedules.
REFERENCES
- Adeoye et,al (20018) confidentiality of patients health information
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- Benjamin,B. ( 2010), Medical Records Pub. London: Willian Heinemann Medical Book Limited.
- Berner, E.S. (2008). Data Quality in the Outpatient settings: Impact of clinical support system.
- Brodnik,Reynolds, 2012). Duty of healthcare professionals to respect patient’s trust and keep their information private.
- Holmes-Rover M. (2002), Improving Informed Consent: insights from behavioral Decision research medical care Huffman (1991): Health Information Management: Physicians Record Comply,Illinos.Pg…780
- Huffman (1972), the three legal theories which may be employed in suit for damages for unauthorized disclosure of information
- MULLET E. (2006), confidentiality is the basis of the legal aspects of health records
- Mulligan, I (2005). Journal on confidentiality of health records
- M.I.A 2001.174, Pg. 657-660
- OSUNDINA (2005) A written authorization be collected from the patient whenever a lawyer or insurance agent wish to see or inspect patient records
