Question

CRITICAL THINKING EXERCISE 4.2 We've given an example of a reasonable safeguard you might take when send- ing PHI by fax. Can you think of safeguards you might need to take when call- ing a patient to let her know the results of a pregnancy test? What precautions might be necessary when emailing instructions to a home care nurse assigned to visit an oncology patient in your practice?

Answer 1

Calling a patient to announce the results of a test would mean there is a possibility of confidential information being leaked to an unauthorised personnel without the knowledge of the patient. And calling a patient for test results for sensitive cases such as pregnancy, all the more precaution and care is mandatory. This can be achieved by taking the following cautionary actions.

• Making sure the one answering the telephone, is in fact the patient. Unreliable methods such as asking the name or trying to recognise the voice of the patient through their past physical interactions should be avoided. Setting a pre fixed password can be of help.
• Not mentioning the type of test performed at all. If only one test has been performed on the patient such as a Urine Pregnancy test, the test results can be announced after confirmation of the identity of the patient, as merely just a positive or negative. the patient will obviously be aware of the kind of test performed anyway.
• E-mailing the test results to the patient, would be a safer method of information delivery.
• Not having a telephonic conversation at all, if possible. This is off course impossible in some cases as the GP;s are ever so busy and this would also require the patient to leave the confines of their home, travel and come to the hospital at a time most feasible to them, which may or may not be the time the Healthcare provider can give to her.

Precautions necessary when emailing instructions to a home care nurse assigned to visit an oncology patient in practice would be:

• Name, age, sex of the patient
• Complete medical history of the patient including allergies and past treatments done.
• Any observation that the physician might have observed while treating the case, which would be of importance to the home care nurse while taking care of the patients such as Anger management issues and mental health disorder
• Sensitivity of the patient towards certain issues, topics, food, colour, etc which could trigger the patient
• The general oncology patient care guidelines and instructions
• since most of the physical environment setting in the patients house is outside the control of the nurse, he/she must take precautions to provide the patient with the best care, as much as possible.