patient privacy and confidentiality

Introduction

patient privacy and confidentiality are core principles of medical care and unless there are specific or extenuating circumstances private information should not be disclosed to third parties without the patient's consent
this also means that hospital staff are generally NOT permitted to view a patient's record or investigation results UNLESS either:
- they are required to as part of their professional work such as:
  - direct care of that patient as part of the care team
  - supervisory management of that patient
  - managers or their delegates investigating quality issues or following up potentially missed investigation results

suspected children or vulnerable persons at risk of abuse or negligent care
blood alcohol testing for traffic trauma (although patient's can refuse but then a notification of this refusal is sent to Police in Victoria)
certain infectious diseases
patients placed under the Mental Health Act
various other legislated situations

one can use or disclose health information where it is unreasonable or impracticable to obtain consent to the use or disclosure, and there is reasonably belief the use or disclosure is necessary to lessen or prevent a serious threat to the life, health or safety of any individual, or to public health or safety
- must have a reasonable basis for this belief, and it must be able to justified
  - eg. a significantly cognitively impaired person unable to make informed decisions absconds from the ED, it then potentially is a duty of care for the ED staff to contact police to as a minimum do a welfare check or bring the patient back to ED for the patient's own safety.
- the test is what a reasonable person, who is properly informed, would believe in the circumstances
- HOWEVER one CANNOT avoid obtaining consent just because it would be inconvenient, time-consuming or impose some cost. Whether these factors make it impracticable to obtain consent will depend on whether the burden is excessive in all the circumstances.
in Victoria, if the organisation suspects unlawful activity has occurred and using or disclosing personal information is necessary to investigate or report this activity;