Academic literature on the topic 'Commission of Inquiry into the Confidentiality of Health Information'

The aim of the study was to compare the opinions of physicians and patients about confidence and confidentiality in inpatient personal healthcare institutions. Material and methods. From November 2006 to February 2007, a survey was performed in seven randomly selected hospitals of two counties of Lithuania. The study included all patients who on the day of the inquiry were undergoing treatment in the departments of internal diseases and surgery, as well as all physicians who were working in these departments on that day. The exclusion criteria were severe health condition and recent admission to the department. In total, 494 questionnaires were distributed; 366 of them were distributed among patients (response rate was 71.3%) and 128 among physicians (response rate was 70.3%). Results. Nearly all inquired patients (94.2%) stated that they trusted their physician. There were no differences between the physicians’ and the patients’ opinions in this respect. Respectful communication is one of the preconditions for confidence between a physician and a patient. According to the findings of our study, 94.2% of patients thought that physicians communicated with them in a respectful manner, whereas according to 62.8% of physicians, patients communicated with them respectfully, and according to 36% of physicians – partially respectfully. Confidentiality was evidently associated with confidence. According to the findings of our study, 38.3% of patients thought that information about their disease and the results of their medical examinations were classified, but as much as 39.5% of patients did not have any clear opinion on this issue. The majority of the physicians thought that they ensured confidentiality of information about their patients’ health status (97.7%), diagnosis (100%), the findings of medical examinations (100%), applied treatment methods (97.7%), and prognosis of treatment (94.2%). Conclusions. Patients evaluated their confidence in physicians very highly. Both physicians and patients provided positive evaluations of mutual communication. The situation with information provided to the patients and the confidentiality of the results of medical examinations in inpatient personal healthcare units remains indeterminate. More than one-third (38.3%) of patients thought that information about their disease and the results of medical examinations were classified, whereas 39.5% of patients did not have any clear opinion on this issue. Nearly all of the physicians thought that they ensured the confidentiality of information about their patients, but they also stated that the assurance of the confidentiality of information is the responsibility of all parties involved, including patients themselves, rather than only the medical personnel.

With the amount of publicity given to the Commission of Inquiry on the Blood System in Canada (Krever Commission), hospitals will be pressured to change policies and procedures regarding transfusions and the use of drug alternatives to surgical blood transfusions. Over the next year, hospital administrators will be forced to implement changes regarding allocation of resources, upgrades to information systems and revised patient care practices for patients requiring transfusions or blood alternatives. At a series of focus groups organized by the Canadian College of Health Service Executives and Janssen-Ortho Inc. in early 1996, 57 health care administrators from across Canada discussed their vision of how the Krever Commission has and will affect hospital policies and procedures over the next few years. This article summarizes the groups' findings relating to the changes that hospital administrators are likely to implement across Canada in the next two to three years as a result of the Commission's activities.

In the article, the author investigated confidentiality as a principle of the organization and activity of the advocacy. The difference between confidentiality and attorney-client privilege was analyzed. The author concludes that confidentiality as a principle of the advocacy is a set of legal prescriptions that determine the mechanism for observing attorney-client privilege, protecting personal data and other types of information with limited access in the process of practicing law, as well as qualification, disciplinary and other types of proceedings in the system of advocate's self-government. Attention is drawn to the fact that, unlike many other principles of the advocacy, the principle of confidentiality applies to a wider range of subjects, including not only advocates, but also assistant advocates and interns of advocates, persons who have an employment relationship with a advocate, as well as persons in respect of whom the right to practice law has been terminated or suspended. Arguments were given in favor of applying the concept of limited protection of attorney-client privilege in Ukraine. The author justified the need to supplement article 22 of the Law of Ukraine “On advocacy and advocate's activity" with part eight of the following content: "An advocate does not bear disciplinary, administrative, civil and criminal responsibility for providing the central executive body implementing state policy in the field of crime prevention and counteraction with information that constitutes attorney-client privilege, in order to prevent the commission of a serious or particularly serious crime against the life and health of an individual”.

ntroduction: The Covid-19 pandemic has left a serious impact on the lives of people globally. One key social consequence of the infection has been the stigma associated with it. Objectives: This study was conducted to explore the lived experiences of stigma among persons who have recovered from Covid-19 in Chennai, India. Methods: In depth telephonic interviews were conducted among 12 persons who had recovered from Covid-19 in Chennai. The participants were encouraged to narrate their experiences of stigma. The telephonic interviews were transcribed and coded by both the researchers. The codes were then grouped into meaningful themes and the lived experiences of stigma described with the help of rich narrative quotes. Results: The common manifestations of stigma were exclusion from public spaces and essential services, loss of livelihood, loss of social support and, in an extreme case, physical violence. The stigma was also manifested in health facilities in the form of neglect, and rude and insensitive treatment of patients. The factors that aggravated the stigma included fear of infection, lack of information, legitimisation of segregation by forced public health interventions, involvement of police in contact tracing, and isolation. Stigma was associated with psychosocial consequences such as loneliness, uncertainty, anxiety, anger, and humiliation. Demonstration of empathy, advances in communication technology, solidarity in communities and protecting confidentiality could potentially mitigate stigma. The intersectionality of age, gender, poverty, and disability worsened the experience of stigma. Conclusions: People who had recovered from Covid-19 experienced various degrees of social stigma. The future impact of the pandemic will depend strongly on the ability of health systems to address stigma.

There have been a number of important developments in Australia in the area of telemedicine. At the national level, the House of Representatives' Standing Committee on Family and Community Affairs has been conducting the Inquiry into Health Information Management and Telemedicine. The Australian Health Ministers' Advisory Council has supported the establishment of a working party convened by the South Australian Health Commission to prepare a detailed report on issues relating to telemedicine. State governments have begun a number of telemedicine projects, including major initiatives in New South Wales and Victoria and the extensive development of telepsychiatry services in Queensland. Research activities in high-speed image transmission have been undertaken by the Australian Computing and Communications Institute and Telstra, and by the Australian Navy. The matter of the funding of both capital and recurrent costs of telemedicine services has not been resolved, and issues of security and privacy of medical information are subject to discussion. The use of the Internet as a universal communications medium may provide opportunities for the expansion of telemedicine services, particularly in the area of continuing medical education. A need has been recognized for the coordinated evaluation of telemedicine services as cost-benefit considerations are seen to be very important.

Among the casualties in the ‘war on terror’ is the presumption of innocence. It is now known that four Canadians who were the subject of investigation by the RCMP and CSIS were detained and tortured in Syria on the basis of information that originated in and was shared by Canada. None has ever been charged with a crime. On their return home, all four men called for a process that would expose the truth about the role of Canadian agencies in what happened to them, and ultimately help them clear their names and rebuild their lives. To date, in varying degrees, all four men continue to wait for that “process.” In this paper, I examine the access to justice mechanisms available to persons who are wrongfully accused of being involved in terrorist activities. Utilizing the case study of one of the four men, Abdullah Almalki, I explore the various processes available to him: (i) a complaint to the relevant domestic complaints bodies, the Security Intelligence Review Committee and the Commission for Public Complaints Against the RCMP; (ii) a commission of inquiry; and (iii) a civil tort claim. Due in large part to the role national security confidentiality plays in these mechanisms, all three models are found to be ineffective for those seeking accountability in the national security context.Parmi les victimes de la «guerre contre le terrorisme» figure la présomption d’innocence. On sait maintenant que quatre Canadiens qui ont fait l’objet d’enquêtes par la GRC et le SCRS ont été détenus et torturés en Syrie suite à des renseignements ayant leur origine au Canada et partagés par le Canada. Nul d’entre eux n’a jamais été accusé de crime. À leur retour, tous les quatre hommes ont demandé un processus qui exposerait la vérité au sujet du rôle d’agences canadiennes dans ce qui leur est arrivé et qui éventuellement leur aiderait à rétablir leur réputation et refaire leur vie. À ce jour, à des degrés divers, tous les quatre hommes attendent toujours ce «processus». Dans cet article, j’examine les mécanismes d’accès à la justice à la disposition de personnes accusées faussement d’implication dans des activités terroristes. Par le biais de l’étude du cas de l’un des quatre hommes, Abdullah Almalki, j’explore les processus divers à sa disposition : (i) une plainte aux organismes pertinents qui reçoivent les plaintes au pays, le Comité de surveillance des activités de renseignements de sécurité et la Commission des plaintes du public contre la GRC; (ii) une commission d’enquête; et (iii) une réclamation en délit civil. En grande partie à cause du rôle que joue la confidentialité pour la sécurité nationale au sein de ces mécanismes, les trois modèles s’avèrent tous inefficaces pour ceux et celles qui recherchent la responsabilisation dans le contexte de sécurité nationale.

e17551 Background: From March until October 2008, a Commission of Inquiry was held in St. John's, Canada, investigating systemic errors leading to incorrect ER results in BC patients. 386 ER negative BC samples tested between 1997 and 2005 were incorrect. Of 91 witnesses, 26 physicians testified about their roles in this “crisis.” Physicians have traditionally been trained to respond to individual clinical crises and acute traumatic situations. This study summarizes the physicians’ training and preparedness in response to a systemic organizational crisis. Methods: Inquiry exhibits, submissions, and transcripts of physician testimony were reviewed for evidence of education and experience in crisis management (CM) as applied to a complex organization. Education and experience with organizational health care crisis were tabulated and prevalent themes relevant for physicians summarized. Results: Evidence was reviewed from 5 oncologists, 17 pathologists, 1 health information analyst, and 3 senior physician leaders. 20 physicians held departmental or divisional leadership roles, one had an advanced degree in Public Health and one had direct experience in a complex private organization. 5 out of province expert consultants had direct experience with continuous quality control applied to large organizations. No physicians were formally trained in CM in terms of acute crisis response. Two prevailing concerns were expressed: 1) delayed and incomplete disclosure of information to patients and public, and 2) numerous preceding systems problems identified by physicians that did not translate into necessary systemic changes to prevent the crisis. Conclusions: The practice of CM recognizes the need to eliminate technological and human systems failure and to develop formal communication systems to avoid or to manage crisis situations. Large-scale organizational crisis management is an important concept for physicians to understand and actively participate in their professional roles. At present most physicians do not receive formal training in CM. No significant financial relationships to disclose.

Objective Capital is an essential enabler of contemporary public hospital services funding hospital buildings, medical equipment, information technology and communications. Capital investment is best understood within the context of the services it is designed and funded to facilitate. The aim of the present study was to explore the information on capital investment in Australian public hospitals and the relationship between investment and acute care service delivery in the context of efficient pricing for hospital services. Methods This paper examines the investment in Australian public hospitals relative to the growth in recurrent hospital costs since 2000–01 drawing from the available data, the grey literature and the reports of six major reviews of hospital services in Australia since 2004. Results Although the average annual capital investment over the decade from 2000–01 represents 7.1% of recurrent expenditure on hospitals, the most recent estimate of the cost of capital consumed delivering services is 9% per annum. Five of six major inquiries into health care delivery required increased capital funding to bring clinical service delivery to an acceptable standard. The sixth inquiry lamented the quality of information on capital for public hospitals. In 2012–13, capital investment was equivalent to 6.2% of recurrent expenditure, 31% lower than the cost of capital consumed in that year. Conclusions Capital is a vital enabler of hospital service delivery and innovation, but there is a poor alignment between the available information on the capital investment in public hospitals and contemporary clinical requirements. The policy to have capital included in activity-based payments for hospital services necessitates an accurate value for capital at the diagnosis-related group (DRG) level relevant to contemporary clinical care, rather than the replacement value of the asset stock. What is known about the topic? Deeble’s comprehensive hospital-based review of capital investment and costs, published in 2002, found that investment averages of between 7.1% and 7.9% of recurrent costs primarily replaced existing assets. In 2009, the Productivity Commission and the National Health and Hospitals Reform Commission (NHHRC) recommended capital, for the replacement of buildings and medical equipment, be included in activity-based funding. However, there have been persistent concerns about the reliability and quality of the information on the value of hospital capital assets. What does this paper add? This is the first paper for over a decade to look at hospital capital costs and investment in terms of the services they support. Although health services seek to reap dividends from technology in health care, this study demonstrates that investment relative to services costs has been below sustainable levels for most of the past 10 years. The study questions the helpfulness of the highly aggregated information on capital for public hospital managers striving to improve on the efficient price for services. What are the implications for practitioners? Using specific and accurate information on capital allocations at the DRG level assists health services managers advance their production functions for the efficient delivery of services.

The article discusses the proof of improper performance of professional duties by a medical worker. It is noted that rare cases of criminal prosecution of medical workers for failure to perform or improper performance of their professional duties, which are reflected in judicial statistics against the background of numerous complaints of victims in health facilities, are caused by the lack of evidence for the prosecution. According to the verdicts, evidence of the commission of these crimes are testimonies, documents and conclusions of examinations. The originals of medical documents are especially important, which, in order to be admissible in proof, should appear on the side of the prosecution in accordance with the law, including the one that regulates medical activities, storage and access to documentation, which may contain information that constitutes medical confidentiality. It is recommended to involve specialists in the field of medicine to participate in procedural actions, as they expertly help the investigator to collect traces of the use of medicines and find out other issues. Commission forensic medical examination in cases of professional activity violations by medical workers is mandatory, as it solves the issue of the presence of defects in their actions. It is noted that the Rules for the Commission of Forensic Medical Examinations, approved by the Ministry of Health of Ukraine in 1995, provide for the possibility of inclusion in the commissions, along with experts, specialists of other specialties, which was allowed by the Criminal Procedure Code of Ukraine in 1960. Since the Criminal Procedure Code of Ukraine of 2012 does not provide such an opportunity, the conclusions obtained by such commissions should not be used in making procedural decisions. To solve this problem, it is proposed to fix in the Code of Criminal Procedure of Ukraine the procedure for attracting to conduct comprehensive and commission forensic examinations necessary to ensure their objectivity and completeness of specialists from among those who are not forensic experts. The proposed changes to the law, as well as the recommended approach of the investigator and the prosecutor to determine the means of evidence will contribute to a better and faster investigation of the non-fulfillment or improper performance of medical duties by medical workers and will strengthen the prosecution’s position in court when considering cases of this category.

Objectives: Despite the growing interest and efforts by government to make popular use of antenatal care (ANC) services in Nigeria as recommended by the World Health Organization, high level of infant and maternal mortality remains a major public health challenge facing the country. Dissatisfaction toward ANC services among pregnant women may be attributed to low level of awareness. This study assessed the level of awareness and satisfaction of ANC services among pregnant women in Lagos state, Nigeria. Material and Methods: The study adopted a survey research design. A multistage sampling technique was utilized to recruit participants for this study. A validated questionnaire was used for data collection and data were analyzed using both descriptive and inferential statistics. Ethical approval was obtained from Babcock University Health Research Ethics Committee with approval no: BUHREC543/17. Approval was also obtained from health service commission and in the six general hospitals used for the study. Informed consent was taken and respondents were reassured of the privacy and confidentiality of the information obtained. Results: The results showed that most of the respondents (85.6%) were in their reproductive years, that is, ages 23–37. The results showed that the level of awareness had a significant influence on pregnant women’s satisfaction with the services (β = 0.460, F(1,1313) = 351.499, R2 = 0.211, P < 0.05). The level of awareness of ANC services was high (M = 4.31, SD = 1.01) on a scale of 5. Conclusion: The study concluded that awareness of ANC services positively impacts pregnant women’s satisfaction with the services in Lagos state. Efforts should be made to improve the level of awareness of pregnant mothers to achieve greater satisfaction with ANC services in Lagos state.

Government agencies collect and disseminate data that bear on the most important issues of public interest. Advances in information technology, particularly the Internet, have multiplied the tension between demands for evermore comprehensive databases and demands for the shelter of privacy. In mediating between these two conflicting demands, agencies must address a host of difficult problems. These include providing access to information while protecting confidentiality, coping with health information databases, and ensuring consistency with international standards. The policies of agencies are determined by what is right for them to do, what works for them, and what they are required to do by law. They must interpret and respect the ethical imperatives of democratic accountability, constitutional empowerment, and individual autonomy. They must keep pace with technological developments by developing effective measures for making information available to a broad range of users. They must both abide by the mandates of legislation and participate in the process of developing new legislation that is responsive to changes that affect their domain. In managing confidentiality and data access functions, agencies have two basic tools: techniques for disclosure limitation through restricted data and administrative procedures through restricted access. The technical procedures for disclosure limitation involve a range of mathematical and statistical tools. The administrative procedures can be implemented through a variety of institutional mechanisms, ranging from privacy advocates, through internal privacy review boards, to a data and access protection commission.