Use of Personal Communication Devices in Patient Care Settings

What principles of patient confidentiality might be an issue? Consider legal and ethical. The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that protects the privacy of individual health information. HIPAA applies to healthcare providers, health plans, and healthcare clearinghouses. Under HIPAA, covered entities are required to protect the confidentiality of patient health information (PHI). PHI is any information that can be used to identify a patient and that relates to the patient's past, present, or future physical or mental health condition, the provision of healthcare to the patient, or the payment for the provision of healthcare to the patient. In the case of the nurse using a personal cell phone to take a photo of a patient's wound and then sending a message with the photo to the primary care provider via a text, the following principles of patient confidentiality might be at issue:

• Consent: The nurse did not obtain the patient's consent before taking a photo of their wound and sharing it with another healthcare provider. This is a violation of the patient's right to privacy and autonomy.
• Security: The nurse used a personal cell phone to take and share the photo. This is not a secure way to share PHI. Personal cell phones are not typically protected by the same security measures as healthcare organization-issued devices.
• Breach of trust: The patient trusted the nurse to protect their privacy. By taking and sharing the photo without the patient's consent, the nurse violated that trust.

In addition to the legal and ethical concerns, there are also practical concerns about using a personal cell phone to take and share PHI. For example, if the nurse's phone is lost or stolen, the PHI could be accessed by unauthorized individuals. How might this nurse use a communication device to support safe patient practices? There are a number of ways that the nurse could use a communication device to support safe patient practices. For example, the nurse could use a communication device to:

• Communicate with other healthcare providers: The nurse could use a communication device to communicate with other healthcare providers about the patient's care. This could help to ensure that the patient receives the best possible care.
• Educate patients: The nurse could use a communication device to educate patients about their health condition and their treatment plan. This could help patients to make informed decisions about their care and to improve their health outcomes.
• Coordinate care: The nurse could use a communication device to coordinate care with other healthcare providers, such as specialists and home health care providers. This could help to ensure that the patient's care is well-coordinated and that the patient receives the care they need.

What would your organization’s policy on 'personal communication device use in a patient care setting' reveal related to this case? (If your organization does not have a written policy, or you are not currently working in an organization, what do you think should be included in such a policy and why?) Most healthcare organizations have policies that restrict the use of personal communication devices in patient care settings. These policies are in place to protect patient confidentiality and to ensure that patients receive the highest quality of care. A typical policy on personal communication device use in a patient care setting might include the following provisions:

• Personal communication devices should not be used to take or share PHI.
• Personal communication devices should not be used to record or photograph patients.
• Personal communication devices should not be used to distract healthcare providers from their work.
• Personal communication devices should not be used to create a hostile work environment.

If the nurse in the case described above worked in a healthcare organization with a policy on personal communication device use in patient care settings, the policy would likely prohibit the nurse from taking and sharing the photo of the patient's wound using their personal cell phone. Conclusion Nurses have a responsibility to protect the privacy of their patients. Using a personal cell phone to take and share a photo of a patient's wound without the patient's consent is a violation of patient confidentiality. There are a number of ways that nurses can use communication devices to support safe patient practices without violating patient confidentiality. For example, nurses can use communication devices to communicate with other healthcare providers, educate patients, and coordinate care. Healthcare organizations should have policies in place that restrict the use of personal communication devices in patient care settings. These policies are in place to protect patient confidentiality and to ensure that patients receive the highest quality of care.  

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