Breaking confidentiality?

RE: Breaking confidentiality?

mariette asselbergs — Thu, 01 Dec 2016 18:24:07 GMT

[quote user="grumpyoldman"]

I have no problem at all forwarding info about unpaid accounts ,if we have been screwed and turned over I think its quite reasonable to try to make sure it does not happen to the clients next potential victim. If I get wind a previous practice has not been paid I insist they go back and pay them and collect the history at the same time ,and refuse to see it until the other practice have been paid in full. When its your time and drugs they are stealing data protection becomes a murky shadow for bad people to hide in.

[/quote]

To be honest, this does not apply to this client. She had lent £400 for a spay plus mammary gland removal, and had no money for an OOH fee for post op bleeding which at her own practice would have been free of charge. Totally understandable and acceptable.

I now realised that we have another complication for this sort of situation. This does not apply for this case.

But we have one userpractice with a number of branches, who have made it possible for us to access their clinical records through something called "teamviewer" which works for voyager/jupiter. It is great because we can see an emergency's previous history at any time, and also follow up what happens to "our" patients once back in their own practice.

However, the access means also that we get the bad debtor or write off alerts which come with some patients......

Could that be a problem data protection-wise (for them), or does the fact that we are their OOH provider mean that we sort of belong to the same practice and data protection should not need to apply?

Mariette

RE: Breaking confidentiality?

grumpyoldman — Wed, 30 Nov 2016 23:38:51 GMT

RE: Breaking confidentiality?

Anthony Todd — Wed, 30 Nov 2016 19:44:33 GMT

[quote user="Eilidh Corr"]

Anthony I need to apologise for having a smartphone screen malfunction and accidentally reporting your post - sorry!

[/quote]

News to me, but then I've had so many black, red and single yellows that another anonymous negative opinion re myself is of no special note....

RE: Breaking confidentiality?

Eilidh Corr — Wed, 30 Nov 2016 19:26:57 GMT

I forwarded clinical records to another practice recently. I attached them to an email. The email said:

"Please find histories for X and Y attached.

We usually ask for payment at the time of treatment."

That second sentence is a totally general statement.

RE: Breaking confidentiality?

Eilidh Corr — Wed, 30 Nov 2016 19:23:00 GMT

Anthony I need to apologise for having a smartphone screen malfunction and accidentally reporting your post - sorry!

RE: Breaking confidentiality?

Glenn Hodgson — Wed, 30 Nov 2016 18:05:11 GMT

I think ok to write test declined due to "x" Doesnt matter if "x" is "stressed during last test" or "declined on cist basis" or "dogs sister died when had same test done". Knowing this can help superceeding vet provide a better consultation.

Is it illigal? surely not, think that the wosrt anyone could get for this woult be a frown.

RE: Breaking confidentiality?

Bob Russell — Wed, 30 Nov 2016 16:32:02 GMT

[quote user="mariette asselbergs"]

[quote user="Bob Russell"]

We will avoid clearly stated comments regarding payment issues (bad debtor etc) but will leave 'payment reminder sent' etc as they are factual records.

On occasions I will write comments that allows other vets to read between the lines!

[/quote]

So do I now read between the lines that in your opinion sharing financial information has a confidentiality issue?

Mariette

[/quote]

I very much doubt the legal system would have a problem with sharing accurate financial information but the Data Protection Act would be a concern (as I have no expertise on the matter) as would the wishy washy statements from the RCVS. If in doubt, don't say it!

RE: Breaking confidentiality?

Martin Atkinson — Wed, 30 Nov 2016 15:54:47 GMT

[quote user="robloxley"]Surely if you are recording 'financial information' on a client's record then the Data Protection Act applies?[/quote]My take on this is that there is a difference between stating the client refused to pay or is a bad debt and a note stating account not settled or declined tests for reasons of fiscal constraint.

If you're a bad debtor in any other walk of life this counts against you on a credit score if you apply for finance. How does that information become shared and available. Why does the Data Protection Act not apply to that as well?

RE: Breaking confidentiality?

Rob Loxley — Wed, 30 Nov 2016 15:13:41 GMT

[quote user="mariette asselbergs"]So do I now read between the lines that in your opinion sharing financial information has a confidentiality issue?[/quote]

Surely if you are recording 'financial information' on a client's record then the Data Protection Act applies?

RE: Breaking confidentiality?

mariette asselbergs — Wed, 30 Nov 2016 13:23:56 GMT

[quote user="Bob Russell"]

We will avoid clearly stated comments regarding payment issues (bad debtor etc) but will leave 'payment reminder sent' etc as they are factual records.

On occasions I will write comments that allows other vets to read between the lines!

[/quote]

So do I now read between the lines that in your opinion sharing financial information has a confidentiality issue?

Mariette

RE: Breaking confidentiality?

Bob Russell — Wed, 30 Nov 2016 13:01:17 GMT

We will avoid clearly stated comments regarding payment issues (bad debtor etc) but will leave 'payment reminder sent' etc as they are factual records.

On occasions I will write comments that allows other vets to read between the lines!

RE: Breaking confidentiality?

mariette asselbergs — Wed, 30 Nov 2016 12:48:20 GMT

[quote user="grumpyoldman"]

We do our own OOH, if there are genuine unforeseen post op complications with a genuine case the aftercare is FOC.(rare) If the client has taken it home before being advised to (happens sometimes) or is being a couch case ,(also happens sometimes), or cannot afford hospitalisation then gets scared and wants to bring it back in at 1am, they pay. Basically if they have been cooperative and done as they were told ,we stand it ,if they have been high maintenance,difficult, not followed instructions etc they pay.

I have heard tales of OOH service providers dealing with minor post op issues at several times the cost of the original problem. Its something that always put me off using them. Particularly if the client then comes back onto you for it later. There is also still a problem with clients not being told by the donor practice what the OOH service provisions are and how much it will be costing. There is still a "we tell them if they ask attitude", and there is a scruffy little notice somewhere in the corner of the waiting room. Not surprising then that the odd poorly informed scroat rocks up without any £££ thinking that "the vet who did the surgery will stand behind his work ". What an old fashioned and quaint novel idea.

If you tell the truth ,you do not have to remember what you said ,don't remember anyone being struck off for being honest, although you can and do get told off by the PC thought police for not being cuddly and sweet. So stay with the facts.

[/quote]

My question was mainly about the difference in sharing cinical information, and sharing financial information about a client. Clinical information is obligatory, (we always inform the client that their vet will get an email about every phone call or consultation or hospitalisation they had with us, but is sharing financial information a breaking of confidentiality, even the "owner declined to pay" info?

Mariette

RE: Breaking confidentiality?

grumpyoldman — Sun, 27 Nov 2016 19:14:15 GMT

RE: Breaking confidentiality?

Anthony Todd — Fri, 25 Nov 2016 18:39:33 GMT

Or " Have had no contact, after xyz, despite 3 accounts, one Recorded Delivery" and follow up phone calls"

RE: Breaking confidentiality?

Martin Atkinson — Fri, 25 Nov 2016 17:12:10 GMT

1) Why even mention why they declined. Just say you offered such and such and after consideration the owner declined, the reason is not relevant. The next clinician will read between the lines when they meet the client. I would anyway.

2&3) If they haven't paid just put a note saying payment outstanding, you don't have to say why, that is not casting doubts on their financial circumstances or refusal to pay.

RE: Breaking confidentiality?

mariette asselbergs — Fri, 25 Nov 2016 14:05:05 GMT

Thanks Bob, our charge was 165 for the 3.00 consult and treatment. I would agree to the telephone call idea, but as night owls, we overlap, go off duty at 8.00 am and come on at 19.00 and i rather sleep in the day than have to sort out phone calls to be honest. Nights are long and busy enough. My main hesitation was: is bringing up financial issues like this a "breaking confidentiality" issue?

And of course I wouldn't "blame" anyone for what happened, it's nobody's fault, can happen, but belongs to the post op care by the operating practice in my view. But not sure if I am right, because of course we don't usually attend to post op complications of our emergency surgery OOH patients presented afterwards in the daytime to their own practice.

Mariette

RE: Breaking confidentiality?

Bob Russell — Fri, 25 Nov 2016 13:50:55 GMT

We would expect to cover standard post-op complications but not with Vets Now who managed to charge close to £800 to 'fix' a 1" wound that opened up after I removed a mass from a dogs shoulder. Not really 'at fault' but 'responsible'.

I don't see anything wrong with O declined on cost grounds as there is nothing embarrassing about not having the money for complications.

I would also appreciate a quick call from the vet rather than an email. Easier to sort out if it is client or surgeon or just bad luck when it is not in writing!

Agree stick to facts on paper and say no more than you have too especially if you feel there may be a degree of surgeon 'error'.

Does not seem to be the case here. More one of bad luck!

RE: Breaking confidentiality?

Michael Woodhouse — Fri, 25 Nov 2016 13:28:28 GMT

Keep the clinical history factual - offered X, owner declined. Phone the practice and speak to them. If I'd spayed the bitch I'd appreciate the phone call rather than just a history emailed over. You can say what you need over the phone, and it allows other factors to be taken into account.

(as long as owner had followed our instructions we'd not usually charge for this)