GP Pulse 03.2010 - The Royal New Zealand College of General ...

cornerstone
CORNERSTONE: the
storage of patient records
Cathy Webber
Principal Advisor, Medico-Legal
How often have we all heard the mantra
‘patient-centred care’? Quite often. But
if patients’ needs are truly to be paramount,
the information that GPs write
down about those patients should surely
be a key concern as well.
Patients don’t tend to like the idea of
their medical records being accessible
to all and sundry. Clearly security of
information ought to be a key priority
for general practices, and the importance
of security and privacy is reflected
in the College’s policy on storing medical
records. But after discussions between
the College and the Office of the
able in public,’ and that non-lockable files
be used only in non-public working areas.
In response to a member’s concern,
the College attempted to clarify a 2007
pamphlet from the Commissioner in
regards to storage of paper files. The
pamphlet interprets Rule Five of the
Health Information Privacy Code,
which relates to storage and security of
health information; the core question
was whether practices should have
lockable cabinets for paper files.
The Commissioner made it clear that
she expects all practices to ensure
they have lockable cabinets—having
The Commissioner made it clear that she
expects all practices to ensure they have
lockable cabinets—having them unlocked,
but behind reception, was not enough to
meet this expectation
Privacy Commissioner, in future, that
definition of ‘secure’ needs to change.
The College’s standards for storing medical
records—developed with extensive consumer
input, and in keeping with relevant
legislation—are found in our publication
Aiming for Excellence. This states that ‘the
content of medical records and documents
(paper or electronic) is not identifithem
unlocked, but behind reception,
was not enough to meet this expectation.
The College agreed to inform
RNZCGP members that they should
plan to meet this expectation within
the next five years. Discussions on the
matter are continuing: in the meantime
we refer you to the standards found in
CORNERSTONE through the Aiming for
Excellence document. They can be found
here: www.rnzcgp.org.nz/aiming-forexcellence.
The Privacy Commissioner asked that
the following note on storing paper
records be passed on to GPs.
Rule 5 of the Health Information Privacy
Code requires that health agencies, such
as GPs, take reasonable steps to keep the
health information that they hold secure
against loss, misuse and unauthorised access.
It does not specify exactly how this
should be achieved. What is ‘reasonable’
depends on the circumstances, such as
the nature of the information, the possible
harm if it is lost or inappropriately
accessed, and the practicality (including
space and cost) of securing it. In the context
of complaints that she has received,
the Privacy Commissioner has been of
the view that having lockable cabinets in
which to store sensitive personal information
is an important component of secure
information handling. Even where space
is very limited, a range of lockable cabinets
is now available to ensure information
is secure.
When deciding how to store your patients’
paper records therefore remember
that, while considerations of cost and
practicality are relevant, you need to
ensure that you are protecting your
patients’ records in a way that recognises
their sensitivity and confidentiality and
your own legal obligations.
24 | GP PULSE | MARCH 2010