Health Information Use in Educational Presentations
The Faculty of Medicine & Dentistry (FoMD) has a mandate to train the next generation of healthcare practitioners. Often, case-based presentations are used to provide context and valuable examples to assist in teaching and learning, however, patient confidentiality must be maintained in keeping with the Alberta Health Information Act (HIA). Recent amendments to the HIA in Bill 46 have increased the potential fines for privacy breaches to not more than $200,000 for individuals and a fine of not more than $1,000,000 in the case of any other person.
Health information is information that identifies an individual and is stored in any format that relates to: diagnostic, treatment and care information; and registration information (e.g. demographics, residency, health services eligibility, or billing). Other examples include personal healthcare number, hospital record number, name, address, initials, and possibly even the medical history should the case be quite rare or unusual.
Whenever possible in educational sessions, one should maintain patient confidentiality such as using de-identified information, changing patient demographics such as initials, age, dates etc. When using images, such as from diagnostic imaging, ensure that any patient identifying information has been removed/deleted or blocked out. Note that if one shares a slide presentation with health information masked (e.g. cover up the area with a black box shape) or cropped, the Powerpoint presentation may still allow other viewers with access to the file to remove the mask or uncrop the image. Microsoft has instructions on how to delete the cropped areas of a picture and save the file with the cropped area removed for Powerpoint presentations, which can be found here.
When can health information be used during a presentation?
Those allowed to access health information under the HIA can also access that information for certain secondary uses, such as for educational purposes. For example, a healthcare team member including learners involved in a patient’s circle of care may need to discuss the history and any relevant lab or radiology investigations not only for the ongoing provision of care, but also for educational purposes. A “team meeting” when challenging cases are discussed with colleagues may also have health information visible, however, when possible minimize the use of identifiable information. Participants at team meetings should have the understanding that the use of such information is subject to the HIA.
Ultimately, whenever deciding what information to include or exclude in a presentation or education session, apply the “cardinal principles” of the HIA:
- First determine whether aggregate, anonymized or de-identified information will suffice; and
- When identifiable health information is required, only collect, use or disclose the minimum amount necessary.
The recently updated FoMD policies and procedures for Health Information are available for review under Information and Privacy & IT Security.
References
https://www.rsna.org/practice-tools/protecting-phi-in-presentations
https://www.acr.org/Practice-Management-Quality-Informatics/Informatics/PHI
https://www.fieldlaw.com/News-Views-Events/177702/Alberta-Health-Information-Act-What-Is-Changing
Health Information Act, RSA 2000, c H-5.
See section 1(1)(k) re: definition of “health information”
See sections 57 & 58 re: “cardinal principles”.
See section 107(6) re: fines.