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Utilizing Medical Information for good results without violating an employees right to privacy

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Need for confidentiality between patient and physician ... Disciplines of occupational therapy, ergonomics, physiotherapy, etc. ... – PowerPoint PPT presentation

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Title: Utilizing Medical Information for good results without violating an employees right to privacy


1
Utilizing Medical Information for good results
without violating an employees right to privacy
  • Dr. Ciaran OShea, MD, FCBOM
  • Atlantic Offshore Medical Services
  • November 15th, 2005

2
  • Need for confidentiality between patient and
    physician
  • Principles governing practice of Occupational
    Medicine
  • When can medical information be released?
  • Current practices regarding release of medical
    information

3
Hippocratic Oath (460-377 BC)
  • What so ever things I see or hear concerning
    the life of a man, in any attendance of the sick
    or even a part there from which ought not to be
    noised about, I will keep silent there on,
    counting such things to be inviolably sacred.

4
Principles governing practice of Occupational
Medicine
  • All medical information is confidential between
    patient and health care professional
  • Medical information should be restricted so far
    as possible to health care professionals
  • Medical information should only be distributed on
    a need to know basis
  • The patient has a right of access to all medical
    information regarding his or her health or
    fitness

5
Continued
  • Disclosure of any part of the patient medical
    record to any third party requires the patients
    informed written consent
  • Disclosure of medical information between health
    care professionals where there is consent or
    justification is generally ethically acceptable
  • The physician has an explicit duty to furnish any
    report requested by a patient within a reasonable
    period of time

6
When can medical information be released?
  • Written informed consent from the patient
  • When required by law for example infectious
    disease, court order, subpoena, WHSCC
    legislation, etc.
  • Where there is risk to the health and safety of
    the patient or the public, or risk of damage to
    the environment, project, property, etc.

7
Current practices regarding release of medical
information
  • Fitness statements - pre-employment, return to
    work assessments, etc.
  • Global health statistical information - trends,
    occurrences, etc.
  • Occupational illness or injuries - part of body,
    mechanism of injury etc.
  • Non-occupational heath information, via health
    monitoring programs to develop health and
    wellness strategies.

8
In summary
  • Respect the patients right to confidentiality
  • Encourage release of non sensitive medical
    information on a need to know basis
  • Encourage employees to participate in non
    occupational illness/injury data collection

9
  • The Use of Pre-employment Screening and Testing

10
  • Medical/health assessment for fitness to work
  • Biological screening to manage health effect
    associated with work place hazard exposure
  • Fitness testing for fitness to work evaluation
  • Practical on the job testing
  • Drug and alcohol testing

11
Medical/health assessment for fitness to work
  • Canadian Human Rights/Medical Guidelines
  • Individual fitness for safe work performance
  • Individual fitness to work in the work
    environment
  • Regulated medical standards, for example
    aviation, divers, etc.

12
Biological screening to manage health risks
associated with workplace health hazard exposure
  • Monitoring of health effects of workplace hazard
    exposures for example, audiograms, pulmonary
    function, blood analyses, etc.
  • Pre placement baseline data collection
  • Ongoing monitoring of exposed personnel (health
    surveillance)

13
Fitness testing for fitness to work evaluation
  • Disciplines of occupational therapy, ergonomics,
    physiotherapy, etc.
  • Acceptable and reliable testing tools/protocols
  • Accurate job task requirements data (BFOR)
  • Establish capabilities of existing workforce for
    validation of BFOR

14
Practical on the job testing
  • Color vision deficiency
  • Obesity
  • Permanently impaired, e.g., amputee, hearing
    impaired, etc.

15
Drug and alcohol screening
  • Policy development and implementation
  • Specimen collection and chain of custody
  • Medical review officer/designated employer
    representative
  • Generally post incident, random for safety
    sensitive positions and with cause

16
Summary
  • Program must be consistent, and supported by
    research and literature
  • Program must be in keeping with Canadian Human
    Rights Legislation
  • Program should have clear policies, protocols
    and reporting formats that respect the principles
    of medical confidentiality
  • Program should be supported by senior management
    as well as employee and labor representatives
    before implementation
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