31 May ER Personnel Must Work With Police While Maintaining Patient Confidentiality
MedicalResearch.com Interview with:
Brodie Nolan, MD BSc
PGY3 Emergency Medicine Resident
University of Toronto, Faculty of Medicine
Medical Research: What is the background for this study? What are the main issues?
Dr. Nolan: Police are commonly encountered in the emergency department (ED). They support EMS, transport patients, are a source of collateral information for health care professionals, and help provide a safe environment for hospital staff. However, there is a potential for conflict due to the nature of police investigation and the emergency physician’s duty to protect patients’ confidentiality and personal health information. Any disclosure of patient information to police without consent could potentially violate the patient’s right to privacy of personal health information.
Unfortunately, it is not uncommonly the case that patients in the emergency department for whom the police have an interest are unable or unwilling to provide consent. Education for emergency medicine residents on police-physician exchanges is variable however it is important to understand the legislation surrounding these practices to ensure patients’ rights are protected and avoid any potential for litigation.
Medical Research: What should clinicians and patients take away from your report?
Dr. Nolan: Issues of patient confidentiality with police presence in the emergency department represent a challenging aspect of emergency medical practice. This is why it is best for companies who deal with customers and clients to look into using something like a privacy filter for monitor to go over your computer screens, to ensure that all information is kept confidential. Only the person looking straight ahead can see what’s on the screen. Regardless of what you are doing on your laptop, it doesn’t give people permission to view content without permission.
In cases where patients are unable or unwilling to provide consent to release of information to police, only limited patient information can be disclosed to police in the absence of a search warrant, court order, or subpoena. That information is limited to the patient’s name, next of kin, and medical status described as stable, fair, or critical. Seven provinces mandate reporting of gunshot wounds to police and four provinces require mandatory reporting of stab wounds that are not self-inflicted. Physicians should be aware of the specific legislations that apply to them.
Strategies aimed at improving communication between police and emergency department staff may improve the process for mental health patients who are brought to hospital by police. Some of these strategies include cross-sectoral training about mental health patients, police calling ahead while en-route to hospital, having an emotionally disturbed person information form that police can fill out to communicate their observations and having adequate staff in the ED to support mental health crisis situations.
Citation:
Brodie Nolan, Alun Ackery. Collaborating With Police in the Emergency Department While Maintaining Patient Confidentiality: How Can We Improve? CJEM, 2015; 1 DOI: 10.1017/cem.2015.5
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MedicalResearch.com Interview with: Brodie Nolan, MD BSc (2015). ER Personnel Must Work With Police While Maintaining Patient Confidentiality
Last Updated on May 31, 2015 by Marie Benz MD FAAD