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Releasing Patient Information

Keeping informed about good practice and guidelines is essential to maintaining and developing medical standards. This is arguably more relevant within the mental health sector where it is hoped that patient confidentiality and record keeping comply with applicable privacy standards and legal regulation. However a question arises, and quite frequently at that, namely, when is it acceptable for your doctor to pass on patient information to another clinician, a third party, or even a family member?

This is well covered in the Irish Guide to Professional Conduct and Ethics for Registered Medical Practitioners where the applicable standards and rules governing patient confidentiality are set out.

Important principles of confidentiality set out in the Guide are:

1. A medical practitioner should not disclose confidential patient information to others except in certain limited circumstances (as outlined below).
2. Patient information remains confidential even after death, however this may remain open to the interpretation of the clinician at hand after taking into account the context of the patient and the patient’s family.
3. A clinician should ensure as far as possible that confidential information in relation to patients is maintained securely and in compliance with data protection legislation.

As well as this, the Guide also offers guidance for medical personnel on what to do in certain situations where medical records are sought by those other than the patient itself:

The certain limited circumstances in which a doctor may release patient information are listed as follows:

• With patient’s consent, to relatives and carers – however if a patient is unable to agree to this, the doctor should consider whether giving the information to family and carers is in the best interests of the patient;
• Required by law – in certain cases, the law requires that clinicians disclose patient information. These circumstances may include: when a judge orders the release of the information, or where infectious disease regulations call for the release of this information;
• In the Interest of the patient or other people – where it is necessary to protect the patient or others from serious risk of death or serious harm;
• In the public interest – Before making such a clinician should consider the possible harm that may result to the patient, as well as the benefits that are likely to arise.

Of particular interest for those curious about their patient records, the section on the Disclosure of Patient Records to other Healthcare Professionals highlights ways in which collected data and patient identity is protected – such as anonymizing data, employing clinical audit and quality assurance systems, informing patients that their data will be shared with other clinicians, and the education and training of clinical staff.

The Guide also helps outline important acts and resources which can help those who are seeking further enlightenment on medical record keeping:

• Freedom of Information Act 1997 www.foi.gov.ie/regulations/regulation
• Data Protection Acts 1988 and 2003 www.dataprotection.ie
• National Hospitals Office Code of Practice for Healthcare Records Management www.hse.ie
• Health Protection Surveillance Centre www.ndsc.ie/hpsc/NotifiableDiseases/NotificationLegislationandProcess/

It is vital for healthcare practitioners as well as patients to remain informed about current guidelines and regulations concerning patient records and confidentiality, so that should a breach occur, it can be rectified immediately and the patient made aware of the occurrence.

The Guide can be accessed on the Irish Medical Council’s website: (www.medicalcouncil.ie ).

Samantha Henson
Clinical Administrative Assistant
Currently studying Healthcare Ethics and Law