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Article
Publication date: 2 December 2020

Ngoako Solomon Marutha and Olefhile Mosweu

This study sought to investigate a framework for ensuring the confidentiality and security of information at the public health-care facilities to curb HIV/AIDS trauma…

Abstract

Purpose

This study sought to investigate a framework for ensuring the confidentiality and security of information at the public health-care facilities to curb HIV/AIDS trauma among patients in Africa. In most instances, trauma to HIV/AIDS patients accelerate because of their personal information relating to the state of illness leaks to public people.

Design/methodology/approach

This qualitative study used literature to study confidentiality and security of information at the public health-care facilities to curb HIV/AIDS trauma among patients in Africa.

Findings

The study revealed that confidentiality and security of information has been neglected, in most instances, at the health-care facilities, and this has, to some extent, affected HIV/AIDS patients negatively, leading to trauma, stigma and skipping of treatment by patients resulting in accelerated mortality among chronic patients. The study recommends that patients’ information be always strictly controlled and kept confidential and secured at all the times, especially that of HIV/AIDS patients.

Practical implications

The proposed framework can be used by health-care facilities to guide the management and promotion of the confidentiality and security of information in the public health-care facilities to curb additional trauma to HIV/AIDS patients in the context of Africa, and even beyond.

Originality/value

The study provides a framework to ensure the confidentiality and security of information at the public health-care facilities to curb additional trauma to HIV/AIDS patients.

Details

Global Knowledge, Memory and Communication, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2514-9342

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Article
Publication date: 13 June 2016

Scott A. Allen and Raed Aburabi

It is a simple fact that prisons cannot exist – practically, legally, ethically or morally – without the support of physicians and other health professionals. Access to…

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322

Abstract

Purpose

It is a simple fact that prisons cannot exist – practically, legally, ethically or morally – without the support of physicians and other health professionals. Access to adequate healthcare is one of the fundamental measures of the legitimacy of a jail or prison. At the same time, there is a fundamental tension in the missions of the prison and doctor. The primary mission of the prison is security and often punishment. Reform and rehabilitation have intermittently been stated goals of prisons in the last century, but in practice those humane goals have rarely governed prison administrative culture. The primary mission of the physician is to promote the health and welfare of his or her patient. The paper aims to discuss these issues.

Design/methodology/approach

At times, what is required to serve the patient’s best interest is at odds with the interests of security. Much of the work of the prison physician does not conflict with the operation of security. Indeed, much of the work of the prison physician is allowed to proceed without much interference from the security regime. But given the fundamental discord in the legitimate missions of security vs medicine, conflict between the doctor and the warden is inevitable.

Findings

In this paper, the authors consider the example of patient confidentiality to illustrate this conflict, using case examples inspired by real cases from the experience of the authors.

Originality/value

The authors provide an ethical and practical framework for health professionals to employ when confronting these inevitable conflicts in correctional settings.

Details

International Journal of Prisoner Health, vol. 12 no. 2
Type: Research Article
ISSN: 1744-9200

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Article
Publication date: 22 August 2007

Richard Cooper

Pharmacy sales of over‐the‐counter medicines in the UK represent an economically significant and important mechanism by which customers self‐medicate. Sales are supervised…

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2583

Abstract

Purpose

Pharmacy sales of over‐the‐counter medicines in the UK represent an economically significant and important mechanism by which customers self‐medicate. Sales are supervised in pharmacies, but this paper seeks to question whether patients' electronic health records (EHRs) – due to be introduced nationally – could be used, ethically, by pharmacists to ensure safe medicines sales.

Design/methodology/approach

Using theoretical arguments, three areas of ethical concern are identified and explored in relation to pharmacists' access to EHRs‐consequentialsim, analogies and confidentiality/privacy.

Findings

Consequentialist arguments include positive benefits to customer's welfare and control of medicine of abuse, but negative economic healthcare burdens and consequences due to potentially increased or paradoxically, decreased presentation of patients to doctors. Socially accepted analogous practices – credit checks, existing pharmacy access to information and hospital treatment – are then argued to be ethically relevant and supportive of access. Privacy and confidentiality are then considered as reasons not to allow EHR access. A contrasting view is that pharmacy access to EHRs is another form of surveillance and hence the question of pharmacists' assess to EHRs may be answered negatively by empirical research that locates pharmacy customers as expert users and identifies confidentiality and privacy concerns about information technology in healthcare more generally.

Originality/value

This paper offers a unique and valuable contribution to the debate about healthcare professionals' role‐based access to patients' medical records and offers a reflection on the ethical concerns surrounding patient information and the rival concerns of patient qua customer autonomy and safety.

Details

Journal of Information, Communication and Ethics in Society, vol. 5 no. 1
Type: Research Article
ISSN: 1477-996X

Keywords

Content available
Article
Publication date: 11 April 2016

Denise L. Anthony and Timothy Stablein

The purpose of this paper is to explore different health care professionals’ discourse about privacy – its definition and importance in health care, and its role in their…

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11616

Abstract

Purpose

The purpose of this paper is to explore different health care professionals’ discourse about privacy – its definition and importance in health care, and its role in their day-to-day work. Professionals’ discourse about privacy reveals how new technologies and laws challenge existing practices of information control within and between professional groups in health care, with implications not only for patient privacy, but also for the role of information control in professions more generally.

Design/methodology/approach

The authors conducted in-depth, semi-structured interviews with n=83 doctors, nurses, and health information professionals in two academic medical centers and one veteran’s administration hospital/clinic in the Northeastern USA. Interview responses were qualitatively coded for themes and patterns across groups were identified.

Findings

The health care providers and the authors studied actively sought to uphold the protection (and control) of patient information through professional ethics and practices, as well as through the use of technologies and compliance with legal regulations. They used discourses of professionalism, as well as of law and technology, to sometimes accept and sometimes resist changes to practice required in the changing technological and legal context of health care. The authors found differences across professional groups; for some, protection of patient information is part of core professional ethics, while for others it is simply part of their occupational work, aligned with organizational interests.

Research limitations/implications

This qualitative study of physicians, nurses, and health information professionals revealed some differences in views and practices for protecting patient information in the changing technological and legal context of health care that suggest some professional groups (doctors) may be more likely to resist such changes and others (health information professionals) will actively adopt them.

Practical implications

New technologies and regulations are changing how information is used in health care delivery, challenging professional practices for the control of patient information that may change the value or meaning of medical records for different professional groups.

Originality/value

Qualitative findings suggest that professional groups in health care vary in the extent of information control they have, as well in how they view such control. Some groups may be more likely to (be able to) resist changes in the professional control of information that stem from new technologies or regulatory policies. Some professionals recognize that new IT systems and regulations challenge existing social control of information in health care, with the potential to undermine (or possibly bolster) professional self-control for some but not necessarily all occupational groups.

Details

Journal of Health Organization and Management, vol. 30 no. 2
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 11 June 2018

Kane J. Smith, Gurpreet Dhillon and Karin Hedström

In this paper, using values of individuals in a Swedish health-care organization, electronic identity management objectives related to security are defined.

Abstract

Purpose

In this paper, using values of individuals in a Swedish health-care organization, electronic identity management objectives related to security are defined.

Design/methodology/approach

By using value-focused thinking, eliciting values from interviews of three groups of health-care staff’s objective hierarchies for three stakeholder groups are identified and defined. Objective hierarchies allow comparison across multiple stakeholder groups such that strategic objectives for identity management can be compared and contrasted.

Findings

This qualitative investigation, which used value-focused thinking, revealed 94 subobjectives, grouped into 12 fundamental and 14 means objectives, which are essential for developing measures that address potential value conflicts in a health-care organization around electronic identity management. The objectives developed in this study are grounded socioorganizationally and provide a way forward in developing measures aimed to reducing potential conflicts at a policy level.

Originality/value

In a final synthesis, congruence (or lack thereof) in the electronic identity management approach for a Swedish health organization is suggested. This also creates a foundation to evaluate and weight different objectives for strategic decision management.

Details

Information & Computer Security, vol. 26 no. 2
Type: Research Article
ISSN: 2056-4961

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Article
Publication date: 20 January 2012

M. Naughton, I. Callanan, A. Guerandel and K. Malone

Medical confidentiality derives from the Hippocratic Oath and has been affirmed in most codes of professional conduct, including the Irish Medical Council's guide to…

Abstract

Purpose

Medical confidentiality derives from the Hippocratic Oath and has been affirmed in most codes of professional conduct, including the Irish Medical Council's guide to professional conduct and ethics. The Irish Data Protection Act 1988 and Amendment 2003 bring this responsibility into a legal forum. The aim of this audit is to assess how comprehensively medical tutors/consultants instilled knowledge and appreciation of confidentiality and data protection to medical students in a prominent Dublin University Hospital.

Design/methodology/approach

Breaches in data protection legislation by final year medical students were identified by means of a questionnaire. Changes were made to the curriculum (presentations, notices on students' e‐learning interface and induction manual) and to the exams in psychiatry, to increase awareness of data protection legislation. Students at the same point in their education were re‐assessed one year later to see if the interventions were helpful in increasing knowledge and improving adherence to data protection legislation.

Findings

Significant breaches of the data protection legislation at baseline and follow up were identified. Examples include: “Data shall be kept for one or more specified, explicit and legitimate purposes” – when asked if they would inform patients that assessments were for submission of a case report, 44 per cent at baseline and 56 per cent at follow‐up said yes. “Appropriate security measures shall be taken against unauthorised access” – 52 per cent password‐protected their computer at baseline and 59 per cent did at follow‐up. Of those that had no password protection at baseline, 70 per cent of their computers were used by others, with little change in this at follow‐up (68 per cent). At baseline 52 per cent kept a copy of reports on USB devices compared to 46 per cent at follow‐up. 26 per cent admitted to losing a USB device in the past. “Data should not be kept longer than is necessary for that purpose” – 63 per cent admitting keeping electronic copies of case reports on their computers following submission at baseline and 64 per cent at follow‐up. “Data should be made anonymous” – 96 per cent at baseline and 100 per cent at follow‐up used initials when submitting case reports to make the data anonymous.

Practical implications

What was disappointing was that, while knowledge and awareness of obligations under data protection legislation improved following intervention, breaches in compliance still remained.

Originality/value

This is the first such audit in Ireland on the provision of educational training in the area of data protection legislation to medical students. It is likely that that such breaches by medical students reflect the tip of the iceberg in relation to probable breaches amongst registered healthcare professionals. The challenge now facing the medical profession and healthcare services is to effect behavioural change to improve compliance with data protection legislation.

Details

Clinical Governance: An International Journal, vol. 17 no. 1
Type: Research Article
ISSN: 1477-7274

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Article
Publication date: 16 April 2018

Gerard Lambe, Niall Linnane, Ian Callanan and Marcus W. Butler

Ireland’s physicians have a legal and an ethical duty to protect confidential patient information. Most healthcare records in Ireland remain paper based, so the purpose of…

Abstract

Purpose

Ireland’s physicians have a legal and an ethical duty to protect confidential patient information. Most healthcare records in Ireland remain paper based, so the purpose of this paper is to: assess the protection afforded to paper records; log highest risk records; note the variations that occurred during the working week; and observe the varying protection that occurred when staff, students and public members were present.

Design/methodology/approach

A customised audit tool was created using Sphinx software. Data were collected for three months. All wards included in the study were visited once during four discrete time periods across the working week. The medical records trolley’s location was noted and total unattended medical records, total unattended nursing records, total unattended patient lists and when nursing personnel, medical students, public and a ward secretary were visibly present were recorded.

Findings

During 84 occasions when the authors visited wards, unattended medical records were identified on 33 per cent of occasions, 49 per cent were found during weekend visiting hours and just 4 per cent were found during morning rounds. The unattended medical records belonged to patients admitted to a medical specialty in 73 per cent of cases and a surgical specialty in 27 per cent. Medical records were found unattended in the nurses’ station with much greater frequency when the ward secretary was off duty. Unattended nursing records were identified on 67 per cent of occasions the authors visited the ward and were most commonly found unattended in groups of six or more.

Practical implications

This study is a timely reminder that confidential patient information is at risk from inappropriate disclosure in the hospital. There are few context-specific standards for data protection to guide healthcare professionals, particularly paper records. Nursing records are left unattended with twice the frequency of medical records and are found unattended in greater numbers than medical records. Protection is strongest when ward secretaries are on duty. Over-reliance on vigilant ward secretaries could represent a threat to confidential patient information.

Originality/value

While other studies identified data protection as an issue, this study assesses how data security varies inside and outside conventional working hours. It provides a rationale and an impetus for specific changes across the whole working week. By identifying the on-duty ward secretary’s favourable effect on medical record security, it highlights the need for alternative arrangements when the ward secretary is off duty. Data were collected prospectively in real time, giving a more accurate healthcare record security snapshot in each data collection point.

Details

International Journal of Health Care Quality Assurance, vol. 31 no. 3
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 23 January 2007

Michelynn McKnight

Critical care nurses' work is rich in informative interactions. Although there have been post‐hoc self report studies of nurses' information seeking, there have been no…

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2709

Abstract

Purpose

Critical care nurses' work is rich in informative interactions. Although there have been post‐hoc self report studies of nurses' information seeking, there have been no observational studies of the patterns of their on‐duty information behavior. This paper seeks to address this issue.

Design/methodology/approach

This study used participant observation and in context interviews to describe 50 hours of the observable information behavior of a representative sample of critical care nurses in a 20‐bed critical care unit of a community (non‐teaching) hospital. The researcher used open, in vivo and axial coding to develop a grounded theory model of their consistent pattern of multimedia interactions.

Findings

The resulting Nurse's Patient‐Chart Cycle describes their activities during the shift as centering on a regular alternation between interactions with the patient and with the patient's chart (in various record systems), clearly bounded with nursing “report” interactions at the beginning and the end of the shift. The nurses' demeanor markedly changed between interactions with the chart and interactions with the patient. Their attention was focused on patient‐specific information. They had almost no time or opportunity to consult published sources of information while on duty.

Originality/value

Libraries often provide nurses with information services that are based on academic models of information behavior. Clinical information systems are designed more for medico‐legal record keeping than for nursing care. Understanding the reality of nurses' on‐duty information behavior may guide librarians and systems designers in the provision of more appropriate systems and services.

Details

Journal of Documentation, vol. 63 no. 1
Type: Research Article
ISSN: 0022-0418

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Article
Publication date: 1 April 2006

Jörg Pont

Health care practitioners in prison face the challenge of providing high standards of health care within the unique peculiarities and restraints of the prison environment…

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382

Abstract

Health care practitioners in prison face the challenge of providing high standards of health care within the unique peculiarities and restraints of the prison environment. The strict adherence to principles of medical ethics by the prison health care staff and the knowledge and acceptance of these principles by the whole prison community not only results in ethical conduct but also yields practical professional advantages such as guidance in situations of conflict, promotion of confidence and avoidance of misunderstandings. The internationally consented conventions, declarations and recommendations relevant on medical ethics in prison are presented and their basic principles ‐ the primary task of the prison doctor, access to a doctor, equivalence of care, patient’s consent and confidentiality, preventive health care, humanitarian assistance, professional independence, professional competence ‐ are discussed. In addition, the personal obligation of the prison doctor for ethical reflection and decision making in individual ethical issues not covered by the quoted documents and in ethically controversial issues is emphasized. A training course and published guidelines for ethical conduct in prison health care are recommended.

Details

International Journal of Prisoner Health, vol. 2 no. 4
Type: Research Article
ISSN: 1744-9200

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Article
Publication date: 9 October 2017

Sadegh Ahmadi Kashkoli, Ehsan Zarei, Abbas Daneshkohan and Soheila Khodakarim

Hospital responsiveness to the patient expectations of non-medical aspect of care can lead to patient satisfaction. The purpose of this paper is to investigate the…

Abstract

Purpose

Hospital responsiveness to the patient expectations of non-medical aspect of care can lead to patient satisfaction. The purpose of this paper is to investigate the relationship between the eight dimensions of responsiveness and overall patient satisfaction in public and private hospitals in Tehran, Iran.

Design/methodology/approach

This cross-sectional study was conducted in 2015. In all, 500 patients were selected by the convenient sampling method from two public and three private hospitals. All data were collected using a valid and reliable questionnaire consisted of 32 items to assess the responsiveness of hospitals across eight dimensions and four items to assess the level of overall patient satisfaction. Data analysis was performed using descriptive statistics and multivariate regression was performed by SPSS 18.

Findings

The mean score of hospital responsiveness and patient satisfaction was 3.48±0.69 and 3.54±0.97 out of 5, respectively. Based on the regression analysis, around 65 percent of the variance in overall satisfaction can be explained by dimensions of responsiveness. Seven independent variables had a positive impact on patient satisfaction; the quality of basic amenities and respect for human dignity were the most powerful factors influencing overall patient satisfaction.

Originality/value

Hospital responsiveness had a strong effect on overall patient satisfaction. Health care facilities should consider including efforts to responsiveness improvement in their strategic plans. It is recommended that patients should be involved in their treatment processes and have the right to choose their physician.

Details

International Journal of Health Care Quality Assurance, vol. 30 no. 8
Type: Research Article
ISSN: 0952-6862

Keywords

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