confidentiality

Re: confidentiality

Evelyn Barbour-Hill — Fri, 03 May 2013 11:05:13 GMT

[quote user="CatherineThomas"]

I'm glad it's not just me who isn't completely clear on what we should and shouldn't be doing in these cases.

[/quote]

A combination of common sense with a smidgeon of conscience should see you through.

Re: confidentiality

CatherineThomas — Fri, 03 May 2013 11:01:02 GMT

I'm glad it's not just me who isn't completely clear on what we should and shouldn't be doing in these cases.

Re: confidentiality

Hannah Wynne Richards — Fri, 03 May 2013 10:51:57 GMT

PS toabove The more information the new owner has then the better for the animal-and to me the bit in our oath-myconstant endevour will be to ensure the welfare of animals committed to mycare out weighs everything else

Wynne

Re: confidentiality

Hannah Wynne Richards — Fri, 03 May 2013 10:49:27 GMT

I would just ink out anything which could possibly identify the owner-or any comments about bad debts-and then forward all clinical details. I wouldn't worry too much if the new owner already knew the original owner as long as that information didn't come from me

Wynne

Re: confidentiality

Ian Mostyn — Thu, 02 May 2013 23:33:45 GMT

[quote user="Martin Atkinson"]does that man comments in the notes can or cannot be included? The rest is crystal clear.[/quote]

If comments relate to the owner or can be used to identify the client then this is confidential. If it relates solely to the animal then that can be included. Calling the owner an idiot should probably be left out

Ian

Re: confidentiality

Gillian Mostyn — Thu, 02 May 2013 23:04:37 GMT

[quote user="Ian Mostyn"]According to the RCVS guide to Professional Conduct:[/quote]

All these points simply pertain to communication between vets, and I am always happy releasing info to another vet if the request is reasonable.

I was always under the impression, though, that Joe Bloggs could not ask for or receive any information from someone else's clinical records, as that information is confidential to that person.

[quote user="Ian Mostyn"]According to a very helpful guy at the Information Commisioners Office[/quote]

All these relate to data protection for personal client info - which can obviously never be released without permission - not to confidential medical information, which is ethical rather than legal issue.

(And yes - we have had this discussion at home....just thought I'd post too! )

Re: confidentiality

Julie Innes — Thu, 02 May 2013 21:32:48 GMT

I always contact the previous VS when taking on a new client (we are a fairly new practice, so we request a lot of histories each day!) I explain to clients that I will be doing this, that it is vital for continuity in their animal's medical notes, and that if they choose to go back to their old vet (eg if they just wanted a second opinion), then I will be happy to pass our records back. This goes especially for people I suspect are coming for a slightly cheaper vaccine/ neutering, as I don't want to encourage this particularly. (I now actually have a client and new client price for vaccines, so that loyal clients get a "discount" and people coming for a cheapie pay more)

Re: confidentiality

Evelyn Barbour-Hill — Thu, 02 May 2013 19:13:29 GMT

[quote user="Ian Mostyn"]Clear as mud [/quote]

Was that a crack? Because it seems pretty clear to me, and entirely sensible. Maybe we're not used to that here.

Re: confidentiality

Martin Atkinson — Thu, 02 May 2013 17:06:50 GMT

[quote user="Ian Mostyn"]Clear as mud [/quote]

[quote user="Ian Mostyn"]7. There would be no problem with sharing clinical records as long as no personal details are included. This would include any comments about the owners in the middle of the notes[/quote] This is the only point which is muddy - does that man comments in the notes can or cannot be included? The rest is crystal clear.

Re: confidentiality

Ian Mostyn — Thu, 02 May 2013 16:50:17 GMT

According to the RCVS guide to Professional Conduct:

1. Clinical & client records including radiographs and supporting documents remain the property of the practice.

2. Clinical records should be passed on to a colleague taking over a case

3. Clinical records should be sought from the original vet on taking over a case

4. Clients permission to pass on information can be express or implied

According to a very helpful guy at the Information Commisioners Office

5. only personal data that can identify the owner is protected

6. Animals have no data protection rights and the owner technically has no right to the clinical details, only to financial and personal information that relates to themselves.

7. There would be no problem with sharing clinical records as long as no personal details are included. This would include any comments about the owners in the middle of the notes

8. There is an expectation that clinical records would be made available to the new owner of an animal (but not any personal data relating to the owner or any financial data).

Clear as mud

Ian

Re: confidentiality

Martin Atkinson — Thu, 02 May 2013 15:58:44 GMT

[quote user="Rob Davis"]there can still be information about them in the notes which ought to be kept confidential, for instance whether or not they returned for reexamination as instructed or carried out recommended treatments[/quote] That information can be deleted/obscured. If someone actually asked me for the owner's details if they re-homed a pet I would not release them without their permission, But I maintain the animal's history is not their property once they don't own the animal and they voluntarily relinquished it and it is doubtful it ever was. I would be happy defending myself on that basis.

Re: confidentiality

Gillian Mostyn — Thu, 02 May 2013 15:19:18 GMT

[quote user="Martin Atkinson"]Data protection protects the client details, so as long as no details of the original client are visible on the animal's history if the animal is no longer their's it is none of their business if the history is made available to the new owner.[/quote]

I interpret the rules differently. I guess that as long as you feel you could defend yourself in case of any accusation of releasing private information, then you're OK. I wouldn't feel happy that I could.

Re: confidentiality

Rob Davis — Thu, 02 May 2013 14:58:22 GMT

Even if the owner's details are removed from the notes, there can still be information about them in the notes which ought to be kept confidential, for instance whether or not they returned for reexamination as instructed or carried out recommended treatments. This can open up cans of worms with new owners if for instance you have recommended a mass excision, dental procedure etc and this has not been done. I would not be happy releasing this sort of information without the previous owner's consent.

Re: confidentiality

Martin Atkinson — Thu, 02 May 2013 14:11:33 GMT

[quote user="Gillian Mostyn"]no, the history belongs to the person who paid your bill.[/quote] In the case where a client requests a second opinion they will invariably be told that we will request the history from their previous vet and they are thereby implicitly agreeing to the history being transferred, if they refuse we don't see the animal. When you are the sender of that history you are assuming the requesting practice has advised the client similarly. However I would argue that the history per se does not belong to the client that is the vet's intellectual property, they only have a right to have a copy of that history. Data protection protects the client details, so as long as no details of the original client are visible on the animal's history if the animal is no longer their's it is none of their business if the history is made available to the new owner.

Re: confidentiality

Michael Woodhouse — Thu, 02 May 2013 12:00:29 GMT

If someone registers with us we ask their previous vets details so we can obtain the history. I see no reason to get it in writing. I take it as implied consent when one of our clients moves away and gives another vet our details that they are happy us passing on their details. They can always lie and say never seen before.

I wouldn't release the history to anyone other than a VS, sorry to the lass re-homing dogs, unless I had permission from the owner. I am more than happy filling in paperwork sent by re-homing charities either in terms of an owner reference or asking about the specific dog if we have seen it. If the charity has a nominated vet practice I would send the history to them, happily.

Re: confidentiality

Hanna Bennett — Wed, 01 May 2013 19:55:16 GMT

We ge owners permission before sending histories to any other parties. Got stung by someone who requested a second opinion then went back to their own vet, to be greeted with some remark on what we'd done and the owner kicked off that no one had asked his permission for info to be passed back and forwards. Obviously there are also RCVS issues here but at the time the VDS advised us to make every effort to obtain verbal consent when anyone requests a history. Occasionally this is not possible but the neighbouring practices have all taken up the habit too so we all know how it works. The data protection act is indeed involved.

Re: confidentiality

Gillian Mostyn — Wed, 01 May 2013 19:44:38 GMT

[quote user="Martin Atkinson"]as Mel suggested the history relates to the animal not the client, if the animals now belongs to someone else so does the history.[/quote]

no, the history belongs to the person who paid your bill.

Re: confidentiality

dogtorate — Wed, 01 May 2013 19:25:59 GMT

Good idea Niall, will the vet need to see the signed form before they agree though, would you request evidence yourself? Our paperwork is due a review prior to us ordering more forms so this can certainly be included, thank you for the suggestion

Sandy

Re: confidentiality

Martin Atkinson — Wed, 01 May 2013 18:55:43 GMT

[quote user="mariette asselbergs"]What is happening is this: a neighbouring practice has a vaccination campaign for large discounts. However, for every animals that is vaccinated there, they use the details to request the histories of all the pets of this particular owner. I am not always convinced that each owner meant to move completely to this new vet practice with all their pets, when they want to use them for cheap boosters once a year. [/quote] Generally the sort of clients who jump ship just for cheap boosters are not very good value clients anyway so I'm not usually too sorry to see them go. My core clients appreciate that I'm not going to subsidise cheap boosters with expensive other treatment and accept paying a bit more for the vaccines. I have a contingency plan for those who do and then creep back expecting me to welcome them with open arms to charge them a re-registration fee but I confess I've not done it yet, just had a little word about the economics of running a practice in their ears. Of course this may eventually come back and bite me and I will have no clients at all but the day that happens i won't want to be a vet and will opt out. Sometimes I'm glad I'm 63.

Back to the OP - I have no problems responding to requests for history, as Mel suggested the history relates to the animal not the client, if the animals now belongs to someone else so does the history.

Re: confidentiality

Evelyn Barbour-Hill — Wed, 01 May 2013 18:23:15 GMT

[quote user="mariette asselbergs"] However, for every animals that is vaccinated there, they use the details to request the histories of all the pets of this particular owner. I am not always convinced that each owner meant to move completely to this new vet practice with all their pets, when they want to use them for cheap boosters once a year. [/quote]

Then don't send the histories, and tell 'em why.

Re: confidentiality

Niall Taylor — Wed, 01 May 2013 17:53:35 GMT

[quote user="dogtorate"] On the application form to re home their dog they are asked to provide the vets details and if the dog has any health problems and to provide the dogs vet history when returning the form[/quote]

Why don't you include a section where they have to sign to authorise their vet to release the dog's records to you, rather than having to rely on the owner to do it?

Niall

Re: confidentiality

dogtorate — Wed, 01 May 2013 17:44:22 GMT

You'd be surprised at the excuses some owners will make when it comes to the previous vet history of the dog they wish to re home, we now find it's easier to contact the vet that has been treating the dog for the information we require. On the application form to re home their dog they are asked to provide the vets details and if the dog has any health problems and to provide the dogs vet history when returning the form, only 2/10 provide the vet history, until we get that history we won't assess the dog because we can't afford to waste what little resources we have on a wasted journey should we find the dog isn't going to be easy to re home. This isn't just because the dog might have a condition which will cost any potential new owner a fortune if they aren't able to insure it it's also a chance to ask if there are any warning markers against the dog for aggression when it's taken in for treatment. We like to be prepared as much as possible!

I appreciate that some dogs are nervous or frightened when visiting the vet, it's usually stated on their history if this is the case but what the owner often chooses not to tell us is they have already spoken to their vet about having the dog pts due to aggression, it seems they are happy for a dog to come in to rescue knowing it is aggressive but don't have the conviction to take it upon themselves to make the decision to have the dog pts themselves thinking that we'll do it for them once we find out what the dog is really like and this is usually after it has bitten someone. We find vets often know more about the dogs temperament than it's owner does. We also have a lot of vets calling us asking if we can help when the owner brings a dog in to be pts because they know the owner is telling a pack of lies just to get rid of the dog and will use aggression as a means of justifying pts.

Sandy

Re: confidentiality

mariette asselbergs — Wed, 01 May 2013 17:18:58 GMT

What is happening is this: a neighbouring practice has a vaccination campaign for large discounts. However, for every animals that is vaccinated there, they use the details to request the histories of all the pets of this particular owner. I am not always convinced that each owner meant to move completely to this new vet practice with all their pets, when they want to use them for cheap boosters once a year.

Mariette

Re: confidentiality

Stephen Courtney — Wed, 01 May 2013 17:17:55 GMT

I don't see why a clinical history cannot be forwarded without personal details of the owner at all - no need to include anything like that, but if i was rehoming a dog and the previous owner refused to sign consent to see medical records....I would not take that animal, wondering what they were trying to hide.

when we get history requests from other vets or insurance companies we just send them. i guess we should check with owners first but if theya re leaving, that could make for an uncomfortable phone call. On the whole, i think I'll continue to apply common sense until such time as I get my ass handed to me. then I'll cry, plead stress, take extra CPD in the field of data protection, and surely will be forgiven by the RCVS

Re: confidentiality

KMurphy — Wed, 01 May 2013 17:10:53 GMT

[quote user="mariette asselbergs"]We get requests of other vet practices all the time to send over animal data , and there is never a consent form of the owner to say that they agree to this. Should we insist on having the consent of the owner to fax data over to another pratice?[/quote]

If another practice contacts me for a history, the owner has given them all their details, the pet's details, and our details so I assume implied consent in this and don't phone the owner to ask their permission prior to faxing a history.

We tell new clients we'll be contacting their previous vets; they very rarely say no.