Lesson 8 Apply The Principles of Confidentiality

Apply the principles of confidentiality, privacy and
security within the medical environment
This unit specifies the outcomes required to apply principles and requirements
relating to confidentiality, privacy and security to own work within the medical
environment.
It covers the elements:

 Work within accepted codes of conduct
 Follow confidentiality and privacy procedures
 Follow security procedures
Introduction
Part of the Hippocratic Oath pledged by doctors states - “I shall respect the
secrets confided in me”. A secretary is the doctor’s agent and is expected (by
law) to do the same. Confidentiality is often broken by carelessness rather than
deliberately. For example:
The list for tomorrow’s patients is on your desk. A patient comes out to
make an appointment, reads the list (upside down) and comments that they
didn’t know “so and so” was attending the same specialist.
You ring a patient’s work number to change an appointment. You give the
correct name and phone extension number and start to say where you are
from when you realise the person you are talking to doesn’t know what
you are talking about. The switchboard operator has put the call through to
a person by the same Christian name at a different extension.
A patient in a small town goes to see her doctor. There is a patient by the
same name and the doctor starts to give out information of an extremely
personal nature when he realises he has the wrong file.
A few guidelines are:
 When people ring for results make sure they are the patient themselves
 Be careful when talking on the phone if patients are waiting in front of you
 Don’t be tempted to discuss matters with family members or friends
 Don’t be tempted to discuss matters with other employees not concerned
with the patient’s treatment
 Never turn the appointment book around to show the patient
 Be careful when sending confidential faxes. It is a good idea to ring the
recipient and advise them to wait by the fax
Work within accepted codes of conduct
When working in a medical office, staff will often come across private and
confidential information. Each practice will often have their own codes of
practice, although government legislation stipulates certain rules.
A good guideline is to put yourself in the place of the patient. Would you like
certain information to be given out if you were in their situation? Obviously
each one of us would like to be treated with respect. Reputations travel quickly.
If we take care to behave with honesty and integrity at all times we will be
known by this. On the other hand word quickly spreads if people find their
private matters have been discussed by unauthorised people. (Legal implications
would also apply).
Clarification should be sought with relevant personnel of unclear or ambiguous

procedures. Ideally the tasks that have been delegated would be under the
supervision of the health practitioner or senior administrator. They would
review and approve any situations involving confidentiality.
Codes of conduct (continued)
Usually administrative matters are handled by the clerical staff, therefore
matters related to health raised by patients are referred back to medical
practitioners.
From time to time there may be a conflict of interest or potential conflict of

interest. For example you may be working in a sensitive area and realise that a
new patient knows you and could be embarrassed if you are aware of their
problem. In this case promptly let the manager or supervisor know of the
situation and they can decide what to do.
It is important that records are kept up-to-date and tasks are completed as
required neatly, accurately and in a timely manner. In this way sensitive
material is not left lying around.
Follow Confidentiality and Privacy Procedures
Privacy Act and Freedom of Information Act

In December, 2001 new legislation came into force regarding privacy laws and
ownership of files (Privacy Act 2001). Another related law is the Freedom of
Information Act.
The Freedom of Information Act 1989 is designed to extend the rights of

the public to obtain access to information and to ensure that records concerning
the personal affairs of members of the public are not incomplete, incorrect, out
of date or misleading. (Release of Information is a simpler method of allowing
you access to your medical record than using the Freedom of Information Act).
Broadly speaking under the Freedom of Information Act a patient can receive
information regarding their own health unless the medical practitioner decides
that it would be detrimental to the patient’s physical or mental health to be
given certain information.
The Privacy Act Under this act information should not be given to third
parties unless the patient has given written permission. There are exceptions to
this rule where certain conditions need to be given to the state health department
or where information is urgently needed for the patient’s treatment. Most
probably senior staff members will have contacted your local state health
department to know what can and cannot be disclosed.
If you are a receptionist or secretary you will be in the frontline for requests for
information. It is important to have a clear idea of what is and what is not
disclosable and also have a standard answer ready for unauthorised requests for
information.
Information requested may include details of patients’ conditions, names and

addresses of patients, financial information, passwords or security arrangements
etc. Discretion and judgement should be used in all communications.
If in doubt always go to the relevant personnel for advice and clarification
where potential confidentiality issues arise in dealings with patients, their
families and others. For example, a member of the patient’s family or another
party may seek to obtain information that is confidential or private and is
insistent that the information is provided.
Patient-related matters should be discussed only within the confines of the

facility and with appropriate personnel. For example:
 A relative comes to visit the receptionist from interstate. She comments

that a local resident has died but no-one knows what from. The
receptionist knows of that patient and the circumstances of their death. (It
is a very small world!)
 A staff member comes out to have a chat with the receptionist about an
interesting letter she has typed. The patient’s relative is sitting within
hearing distance.
Relevant personnelmay include:
 supervisor/manager
 health practitioners
 partners in the business
 other specialised staff
Follow Security Procedures

To maintain confidentiality, privacy and security patient records and other
confidential documentation should be stored and secured appropriately. This
may be in locked filing cabinets or in password protected computers.
From time to time old documents need to be taken to a secondary storage area.
All documents required by legislation to be stored for certain periods of time are
clearly labeled and stored securely according to organisational policies and
procedures. When it comes time to dispose of these records they should be
destroyed and not merely thrown out.
Drugs, equipment and other materials requiring secure storage and potentially
posing an OHS threat to others, should be stored securely at all times.
In Summary
• Be aware of current legislation regarding release of information
• Don’t leave confidential documents lying around
• Don’t discuss confidential and private matters away from the workplace or
with colleagues not involved in the patient’s care
• If in doubt, check with a supervisor or colleague before releasing

information
• Take into account OHS issues when securing drugs etc.

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Apply the principles of confidentiality, privacy and

security within the medical environment

It covers the elements:

Clarification should be sought with relevant personnel of unclear or ambiguous

From time to time there may be a conflict of interest or potential conflict of

Privacy Act and Freedom of Information Act

The Freedom of Information Act 1989 is designed to extend the rights of

Information requested may include details of patients’ conditions, names and

Patient-related matters should be discussed only within the confines of the

 A relative comes to visit the receptionist from interstate. She comments

Follow Security Procedures

• Be aware of current legislation regarding release of information

• Don’t leave confidential documents lying around

• If in doubt, check with a supervisor or colleague before releasing

• Take into account OHS issues when securing drugs etc.

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