Dear Lonny
I'm a specialist involved in a bunch of clinical trials
at different sites. Because I move around a lot I keep
all of my patient data on my laptop, which I carry with
me at all times. Recently one of my co-investigators
started nagging me about this, saying it's a breach
of privacy law. Is he right?
—Confused
About Computer Rules
Dear Confused
Your colleague probably heard about the case of the
Toronto Sick Kids physician who had his laptop swiped
from his van. The computer contained data from several
on-going trials and included detailed info on 2,900
patients, including their HIV status. Though the computer
was password protected, the data was not encrypted.
The Information and Privacy Commissioner of Ontario
was not impressed and determined that Sick Kids' had
not taken steps that were "reasonable in the circumstances"
to ensure the protection of health information. The
hospital was ordered to implement new privacy policies
and to train its staff about privacy issues. I'm afraid
this decision sends a clear message that sensitive patient
information should never be stored on a laptop (or even
sent by email) unless it's de-identified or encrypted.
I'd recommend you keep your data on the servers of your
research sites and access it through a VPN connection.
So sorry, but your colleague is right on this one.
CAREENING
DOWN INFO HIGHWAY
Dear Lonny
I recently joined a group practice where a computer
terminal connected to the internet is available to patients
in the waiting room to keep them occupied while they
wait. I recently found it serves another purpose. My
new colleagues tell me they regularly send their patients
to medical websites instead of "wasting time" explaining
the basics of various diseases and their management.
They urged me to do the same. At first, I was sceptical,
but I found it really saves me time. Is it legally kosher?
— Snagged
by the Net
Dear Snagged
The internet has changed physician-patient interactions
in many ways. Patients now arrive at appointments armed
to the teeth with medical info gleaned from the net,
and frequently challenge their docs about care decisions.
To physicians, this can be a double-edged sword: one
the one hand, score one for patient literacy; on the
other, patients are as likely to get their information
from questionable sources as reputable ones, and you
have no way to gauge if they understood what they read,
or even read the right stuff. I totally get that today's
family docs are run off their feet and seeing more patients
faster seems like a good idea. But when it comes to
counselling patients, you really shouldn't leave it
to the net. Imagine how terrible you'd feel if they
opted for some bogus herbal concoction they found online
instead of taking what you prescribed? When it comes
to disease management or a discussion of risks and benefits
of a course of treatment, you really have to explain
this to the patient as if they have no prior information.
And always document your discussion in the chart.
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