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Minutes of the Privacy and Confidentiality Meeting Held on 13
July 2000 at 12:00 at PQ Africa Park Present: Alice
du Toit Qedi/PQ Health alice@qedi.co.za Braam Volschenk SAMA braamv@samedical.org Heather
Manley Sunesi Clinical Systems hmanley@sunesi.com Henriette
Nortje Qedi/PQ Health henriette@qedi.co.za Jean
le Roux Qedi/PQ Health jean@qedi.co.za Lyn
Hanmer MRC lyn.hanmer@mrc.ac.za Philip
Hosiassohn Health ASP Corp/PESA philiph@healthasp.co.za Rudolf
Visagie Qedi/PQ Health Rudolf@qedi.co.za Apologies: Accepted In attendance: Henriette Nortje Qedi/PQ Health henriette@qedi.co.za 1. Welcome Jean le Roux welcomed everybody. 2.
Previous minutes
were accepted. 3.
Identified concerns Philip Hosiassohn
raised the focus of the pharmacies and diagnostic security of healthcare. Up
to what point is the consent of the patient valid? Specific E-commerce protocols on the web to identify the
confidentiality levels. In the case of smart card usage, where the thumbprint of the patient becomes consent. Heather Manley had
concerns about the exchange of any form of clinical information and the
temporary and permanent storage thereof. Lyn Hanmer
suggested to look at what other people have done and to look at a trusted 3rd
party agent to handle sensitive information like data warehousing. Henriette Nortjé
added that a definite line must be defined between information in a
statistical format in a data warehouse (for example HIV positive patients). Jean le Roux from
an IT point of view, added, who does the information belongs to, and
copyright thereof. . Braam Volschenk
from Samedical suggested that one looks at the various aspects of medical
ethics. Information release to the state and private sector must be
specified. Electronic data is a new field and the committee needs to invite
other companies to give insight in this matter. A new way of delivering the
data must be re-invented. Ethics and law has an impact on what we want to
change. It is not straight forward if you look at different opinions (for
example Prof van Oosden from Tukkies). Jean suggested that more information
must be circulated and placed on the Web. Braam Volschenk is going to Finland
and will share new information with us at the next meeting. This committee
reaffirmed, to look at areas of consent and confidentiality. Human rights
issues are likely to follow, and there is a lot to debate around these issues. One has to have to look at lines
and parameters (for example HIV). A doctor has the right to choose if he/she
wishes to share information or not. The patient has to know, when and who is
going to get the information. A member signs on behalf of his dependant, and
somewhere we have to draw the line on how far information may be released. The only way would be, if you have an
actor, like a Medical Scheme, who has the right to get certain information
for manage care. The doctor makes notes and he/she has the copyright on the
notes, and while you have right to the content, you not entitled to have a
copy of the original. The doctor has to give diagnoses to medical schemes
(for example HIV), the patient has the right to request not to give the
information and the doctor has to keep it to himself. Philip Hosiassohn said
that the information on the smart card about the patient may be shared as
soon as the card is given to the provider. Misuse of the information has to
be stopped. Braam Volschenk says that
it falls under a gray area in law. Heather Manley said
that one should not get confused with consent and identification. Jean le
Roux suggested that a task group be established with enough professionals who
can contribute such that guidelines may be set up. Braam Volschenk said that
we need guidelines urgently and ask people to start working accordingly. A
court will look at the guidelines if they are available. All the role players
have to know how far they can go in connection with information sharing.
Diagnosis codes are there for billing and to motivate the claim. Philip
Hosiassohn asked to whom the data belongs to if it is in data warehouse.
Braam Volschenk replied that that belongs to the doctor. Henriette Nortjé
confirmed this, since the doctor has to give his written consent to release
the data for the warehouse. If a doctor is using the information for any
other purpose, than to get paid from medical aids, the patient should know
about it and give his/her permission. Philip Hosiassohn suggested the focus
should be on consent of the patient/doctor.
4. Proposed action Guidelines should
be prepared for specific cases, especially around patient consent on
information held electronically. Braam Volschenk
explained, that there is an act in Britain, and he will endevour to obtain
the latest information on it, and will e-mail it to Henriette Nortjé for
publication on the web. Jean le Roux will
look at implementation. 6. Next Meeting 12 th, October 2000
at 12:00 at PQ Park __________________ Chairperson ____________ Date |