Too much information

Barb
Barb Sweet
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A reporter’s trip to ER raises privacy concerns

Eastern Health has a policy against disclosing patients’ personal information, but at St. Clare’s emergency room, patients have been routinely publicly asked for phone numbers, addresses, birthdates and other details.

Birthdates are requested, even though they are on the MCP cards patients have already handed over. This practice has gone on since the emergency room was renovated in 2014, until this week, when Eastern Health changed its procedures in response to a Telegram inquiry.

But here’s what this reporter found out last week on my own trip to emergency, not for a story, but for an urgent medical matter.

The clerk who checks in patients sits behind a glass window, with the patient sitting outside the wicket, within easy earshot of other patients in the snug waiting room.

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The space between the front row of waiting room seats and the window behind which staff work is barely wide enough for a wheelchair to be pushed through. So, when any patient at the wicket is asked for details, including next of kin and identifying information, anyone in the room can hear it.

As I took my seat to wait for medical attention in the chair furthest from the check-in wicket, I could hear the questions and replies of the patients who checked in after me.

Each patient was called by name and, in one case, an elderly lady was asked for her birth date, phone number and address. Another was asked and gave details about next of kin.

Why is this too much information? Because many fraud and identity theft websites warn against giving out such personal details publicly.

Eastern Health’s privacy and confidentiality policy states, in part: “It is the responsibility and obligation of all employees, agents and/or those affiliated either directly or indirectly with Eastern Health to ensure that information to which they have access is kept private and confidential.

“All information obtained in the course of an affiliation with Eastern Heath must be held in the strictest confidence. … Understanding the environmental limitations inherent in the health care setting, information that is considered confidential and private is not to be discussed in any public location (elevators, lobbies, cafeterias, off premises, etc.) where others, not entitled to receive that information, are present and likely to overhear.”

Such confidential personal information includes: “the individual’s name, address or telephone number, the individual’s age, sex, sexual orientation, marital status or family status.”

In the ER waiting room, people openly use their cellphones even though there’s a sign on the wall advising they should be turned off. Relatives and friends of patients flow in and out and no one seems to question the presence of anyone who hasn’t been called up for registration or triage.

The renovations at St. Clare’s did improve the medical facilities inside. Once a patient is called to see the triage nurse they are taken behind sliding doors to give medical information and, later, when their turn comes to see the doctor, they are treated in private exam rooms.

The medical treatment I received there was superb, but in recovery I was curious as to whether too much personal and medical information can be overheard in health-care settings.

Absolutely, says the province’s access to information and privacy commissioner.

Ed Ring has not done a formal investigation, but says so based on his own and others’ experiences, including those who have mentioned the issue to him in his official capacity.

“It’s a problem,” Ring said, adding that in 90 per cent of doctors’ clinics in the province there’s not enough privacy.

From doctors’ offices to hospital and clinic wards and rooms where beds are separated by curtains, with patients obliged to answer questions about medications and past medical history, there isn’t much room for modesty, he acknowledged.

Some people don’t want those details shared and others simply don’t want to hear them, Ring said.

He said it’s not unique to this province, as many health facilities around the country were designed long before privacy and confidentiality concerns ramped up.

So while it’s a bad situation, it’s also a hard nut to crack. As new facilities are built, privacy can be taken into account, but it might not always be the case during renovations that must work around old construction, Ring said.

Prior to being renovated, the St. Clare’s ER had a waiting room well away from the rooms where clerks and nurses took information from patients.

Accreditation Canada, which audits the performance of the nation’s hospitals, has mandated in its emergency room standards that patient privacy must be respected. But it hasn’t exactly told the hospitals how to achieve that, a spokeswoman said.

It revised emergency department standards in 2014 and the next year began evaluating how hospitals ensure patient privacy is respected during registration at the ER.

It’s up to the hospital — based on logistics such as layout as well as provincial and federal legislation — to interpret how it complies with the standard.

While hospitals often take basic information at registration and detailed medical information in private, they need to respect a patient’s wishes, Geneviève Brisson, a communications specialist with Accreditation Canada, said in an email response.

“If a patient does not feel comfortable with the way a hospital has defined public versus private information within a physical space, then he/she can request privacy,” Brisson said.

Organizations: Accreditation Canada

Geographic location: Canada

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Recent comments

  • Observer
    February 04, 2016 - 08:14

    They ask birth dates in medical situations, including the pharmacy, here in the US too. It's the protocol to make sure you are the actual person.

  • Audacity
    January 29, 2016 - 10:05

    I can concur that on my one and only visit to emerg, there were people in the waiting room who made no attempt to conceal their obvious listening to me give my personal details to the triage nurse. So, yes, people can be nosy for whatever their own "sick" purposes. Who is going to go know to go through the extraordinary step of giving their phone number and address and emergency contacts in a separate room? I would surmise anyone doing so would risk being treated like garbage by the staff for inconveniencing their delicate systems. Risk being made to wait longer. And if you think such childish stuff doesn't go on at all levels of health care well, you just never saw it or had to deal with it. Momentary lapses of judgement lead to punitive, stupid, even evil comments being put into peoples permanent medical records by doctors that then get picked up by other doctors down the line and literally creates prejudice against patients. It most certainly happens. I've been booted around the 3 to 6 month waitlist system to see specialists who had to be prevailed upon by my assistance to even look at the body part in question, let alone examine it, and when I obtained hard copy of my records, the prejudice became clear, even from individual doctors who were so far out of their area of specialty that they might as well have been speculating on what goes on in a black hole. This is not too far out of the realm of the other comments, because I saw another comment about how staff jokes around at patients expense for their own amusement. Thanks for helping mentally and physically disable me Eastern Health!

  • Janet
    January 29, 2016 - 07:08

    That is the tip of the iceberg. At Health Sciences and St Clare's the "overflow" area in emergency is the halls. Since it is a daily experience, overflow is the wrong word though. Patients on stretchers line the halls and give histories in the hall. There are numbered parking spots for stretchers in the halls of Health Sviences ER with sick, vulnerable people having no curtain or privacy of any kind, sometimes for days while awaiting a bed. If wards and double rooms had not been converted to offices, storage areas, etc over the last number of years, eastern Health could offer these patients some respect a little faster. That is not a priority so why would we expect privacy to be a priority

  • Tracey
    January 28, 2016 - 21:09

    I've twice brought my dad into St. Clare's ER since the renos and we both felt extremely awkward giving personal medical details to the person behind the glass with people so close and passing by. While the treatment received was fairly reasonable, the initial process is unnecessarily embarrassing. Thank you for writing this article.

  • Errol
    January 28, 2016 - 11:55

    This is common in emergency rooms and clinics in NL. The set up of talking to one clerk through a little hole in glass is archaic. I had reason to visit a hospital ER last summer in ON. The initial contact is a triage nurse behind a desk...no screen. Then, if appropriate, you are referred to the waiting room, where you take a number, and are then called to one of several cubicles, where you are documented and an ID bracelet placed on your arm. The wait was a couple of hours, but the care excellent. As to use of cell phones, there is no technical reason not to use them in hospitals. In fact this hospital had the password for their public wi-fi posted in the waiting room, as well as a notice inviting patients to use it...free. It allows the passage of time to be a little more productive. We are a long way behind in NL... Why?

  • been thinkin
    January 28, 2016 - 09:02

    The questions are asked to ensure they have the right persons data and medical file electronically pulled up for the treatment team If someone is sat there with a recorder they might get enough info to call you by name know your husband or wife and figure out your age I think safety of the correct person getting the correct treatment wins this debate

    • Joe
      January 29, 2016 - 08:37

      Gee, I don't think anyone understood that part! Of course, in addition to the problem of identity theft, we might want to respect the fact that there are people in our community who, for very legitimate reasons, may need to protect this information (eg. people fleeing domestic violence, sexual assault victims, queer youth dealing with violent families...)

  • not surprised
    January 28, 2016 - 08:32

    I'm not surprised at this or when the nurses and other staff is "jokingly" talking about a patient that can be heard by other patients either.None should be classed as a "pillhead" and only here to get "pills" but they do it anyways...nothing is private anymore.

  • justin case
    January 28, 2016 - 07:18

    We as a society are becoming paranoid. There seems to be the mind set of "jump on the bandwagon" mentality and close any perceived loophole to potential identity theft. We can't live in glass bubbles every minute of every day. Yes we need to be prudent... but paranoid, I think not. Longing for the good ole days.....

  • User
    January 27, 2016 - 21:23

    The other thing with the 2014 renovations is the new placement of the door. The main walk-in emergency door was in the middle of the courtyard in the middle of the two wings of the hospital. Cars dropping off or picking up would just stop in the courtyard. They slightly slowed down traffic and ambulances, but you could easily get around them. In 2014, they moved the walk-in emergency door to the door in the narrow exit of the courtyard so any cars or ambulances stopping by the door are completely prevented from going past them. In theory, people can still get in or out if their cars in the courtyard and walk to the door at the end of the exit. However, when dealing with the sick and elderly in an emergency situation, you want to get as close to the door as possible, even if it means not thinking straight and blocking off other cars and ambulances. You could pull up to the door along the curb off hospital property to pick up or drop off, but that is not safe or feasible as it it a busy street, cars coming from the west can't turn left to get to it, and cars coming from the east or south have to go around the block or make U-turn in an awkward and unsafe intersection. In an emergency situation you need the easiest and quickest access possible, so the curb is really used.

  • Stephen  Redgrave
    Stephen Redgrave
    January 27, 2016 - 18:11

    People--lets not be flattering ourselves. I could not care less if someone has one testicle, or Jane Doe has had a hysterectomy. Lets direct this paranoia effort into other real Civil Rights Violations--like the ones our provinces children and parents are going through. And, the corpulent corruption of our Justice system at the lower levels. Judges are amazingly honest people.

    • Joe
      January 28, 2016 - 09:03

      Stephen: What civil rights violations are the provinces children going through ? Am I missing something?

    • lynnAnn Noseworthy
      January 30, 2016 - 12:49

      Joe: You ask , "what am I missing" You haven't traveled this country(Island) ...there's no way, or you would see it first hand, while old Newfoundlander's struggle a losing battle to keep the Island like it was in 1945.Not going to happen! We're part of Canada, and Civil rights are your obligation. It's not negotiable , or bendable. We can't keep our kids hidden from the real world.