Confidentiality - what is it?

Confidentiality is respecting a person's right to decide who they share their personal health information with. People have different comfort levels with what other people know - it really depends on the person.

All healthcare workers have a moral (because it's the right thing to do by the person) and legal (because it's the law) reasons and responsibilities to respect confidentiality. Confidentiality is also important in building and keeping patient trust.

What is personal health information?

What is said or done in an appointment or at the clinic	Information from a person's file (including criminal history)
A person's RAMQ (Sun Card) or file number	The reason you're trying to reach someone

Confidentiality Vs. Secret Keeping

Confidentiality is not the same as secret-keeping.

You can't promise to keep everything a person tells you a secret. This is because there are certain situations (usually for the person's, the community' or the healthcare worker's health) where you might need to share some information. It is better not to make promises you can't always keep.

The idea is that confidential health information should ONLY be shared when necessary and with the necessary people.

The PHO is not alone in creating a trusting and confidential environment for patients. It involves all TB Team members!

Secret-Keeping	Confidentiality
Example: DON'T keep the fact that your patient, Jim, has been vomiting for days a secret from the nurse.	Example: DO remind the TB nurse to wear a mask because the patient you're visiting is still in isolation.

Ways to Keep Confidentiality as the PHO

In Person

TO DO	HOW
Try to keep a person's privacy during appointments	Keep the door closed or ask another patient to wait in the waiting room if you are in an appointment with someone else.
Think about who you are sharing people's info with	Other healthcare workers: Only share what is necessary. Community: Pretty rare to need to share personal health information.

On the Phone

TO DO	HOW
Avoid calling someone with another patient in the room	Wait or use a phone in another room.
Only share information with the person you are trying to reach	Don't share unnecessary information if someone else in the house picks up first.

A Story

TO DO	HOW
Avoid sharing details of a story that make it clear who you are talking about	Take names, dates, and places out of the story. Consider if you can tell the story without giving away who it is.

Files

TO DO	HOW
Avoid looking at information that doesn't directly relate to your work	Example: if you are checking if someone had the TB vaccine, you probably don't need to check in the mental health section.

Shred

TO DO	HOW
Don't leave papers out or share lists with people's personal info on them	Example: if you're sending a list of people to FM, include only the people's name (no file numbers or no reasons why they are being called). You could just say something general like "Call the CSLC" or "Come to the CLSC"
Shred paper with personal information when they aren't needed anymore

Examples

Check out the examples below. Each situation is unique. That’s why it can be really helpful to talk about it with your TB team.

Example #1: You see the mayor at the COOP, and they ask you if Martha has TB.

Say → "It's not really up to me to share that kind of information"

Even though the person might mean well, it is still another person's decision to share their health information or not.

Example #2: You call at Juanasie's (26 years old) place but his mother answers.

Say → "Yeah, I'm sorry but I'm not allowed to share specifics with anyone but Juanasie. If you could just pass the message for him to call me back."

Even though she's his mother, as an adult, he has the right to decide what he shares with her.

Example #3: You're in the busy daycare office and a daycare worker, Davidee, asks if his test results are in.

Say → "I'm not sure about your test results, but do you want to talk somewhere more private."

Even though Davidee starts the conversation (and we love that people feel comfortable talking to us), we still want to offer him privacy when possible.