BHB Tackles Healthcare Ethics in the Digital Age

The Ethics Committee of the Bermuda Hospitals Board (BHB) is tackling the complex issue of Ethics of Healthcare in the Digital Age during its annual Ethics Awareness Week, which launches Monday 5 November 2012. Members of the Ethics Committee will be available to discuss this subject and their role at BHB between 9.30am to 11am on Monday 5 November in the lobbies of the King Edward VII Memorial Hospital and Mid-Atlantic Wellness Institute.

The goal of the week is to highlight how patient confidentiality is being protected as digital technology is increasingly used in the clinical environment to improve communications. While educating healthcare staff about safeguarding patients digital information and images is a key part of the week, equally important is the role that patients and visitors themselves play.

Dr Elaine Campbell, Chair of the Ethics Committee, and an Anaesthetist at KEMH comments: “People have their cell phones and other handheld electronic devices, such as iPads, on them just about all the time. There are strict expectations for how clinicians will use these devices, but most people have got so used to phoning, texting or emailing people and posting short updates, images and videos about their lives to social media sites such as Facebook and Twitter, they don’t always consider the many ways they can inadvertently breach confidentiality and make an individual’s healthcare information public. For example, taking a photo of someone getting medical attention after a road accident and sharing that photograph is a serious breach of that person’s trust and confidentiality if they haven’t given their consent.”

Examples include:
• Taking photos or videos of accidents, or emergency patients out in the community
• Informing people that someone has been taken to hospital without their permission
• Taking photograph of mental health service users in the community or near MWI
• Taking photos or videos in healthcare environments of others and catching someone else in the background
• Texting or emailing that you have seen someone in hospital
• Writing on public message boards about other people’s healthcare treatment or experience

Dr Chantelle Simmons, Chair of the Ethics Education Subcommittee and Chief of Psychiatry at MWI, adds: “It is not just the sophisticated technological advances that can make a big impact on healthcare. Everyday technology has vastly improved the efficiency of our clinical services. Clinicians can share information and images easily on handheld devices and improve the coordination and standard of care. In addition, patients have unprecedented access to medical information to enhance their understanding of their conditions, treatments and care, which facilitates informed discussions with their treatment team. However, there can be risks associated with the use of technology. Our goal for this week is to highlight ways in which we can we maintain the high standards of patient confidentiality while improving the efficiency of clinical care. It is important that patients know they remain in control of their personal healthcare information whether it is on paper or digital. Their consent must be sought for any photography or video and they have a right to know and control who accesses their information.”

Although BHB systems are heavily protected, the use of handheld devices means that healthcare workers need to be even more vigilant in protecting information. Advice being provided to healthcare workers regarding the protection of digital information includes:
• Only emailing patient information to secure email addresses, preferably to emails within BHB
• Never putting a patient’s name in the subject line of an email
• Setting strong passwords on all electronic handheld devices, and setting short time outs to minimize the risk of someone picking up the device and accessing it
• Always seeking patient consent for any photo or video being taken and for how it will be used, even if it is for clinical reasons
• If a patient is inadvertently captured in the background of an image, it should be either deleted or consent requested from the patient prior to distribution
• If a handheld device is used to take a photo or video with a patient’s consent, the image should be emailed to a BHB email only and deleted from the handheld device as soon as possible

The Ethics Committee comprises about 20 members including clinical, administrative and community representatives. It offers consultations to patients, families and healthcare professionals when dealing with ethical issues around medical care. The Ethics Committee can be contacted for a consultation by members of the public by calling 291-HOPE and leaving name and contact details.

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