Abstract
Background: The Picture Archiving and Communication System (PACS) has led to an increase in breached health records and violation of patient confidentiality. The South African constitution makes provision for human dignity and privacy, virtues which confidentiality seeks to preserve. Confidentiality thus constitutes a human right which is challenged by the use of technology. Humans, as managers of information technology, constitute the weakest link in safeguarding confidentiality. Nonetheless, it is argued that most security breaches are nonintentionally committed by well-meaning employees during routine activities.Objective: The purpose of this article is to explore the nature of and reasons for confidentiality breaches by PACS users in a South African context.Methods: A closed-ended questionnaire was used to collect quantitative data from 115 health professionals employed in a private hospital setting, including its radiology department and a second independent radiology department. The questionnaire sought to explore the attitudes of participants towards confidentiality breeches and reasons for suchbehaviour.Results: Breach incidences were expressed as percentage compliance and classified according to the nature and reasons provided by Sarkar's breach classification. Cross tabulations indicated a statistical significance (p < 0.00) between the expected and observed confidentiality practices of participants and also the adequacy of training, system knowledge and policy awareness.Conclusion: Our study supports previous findings that, in the absence of guidelines, most security breaches were non-intentional acts committed due to ignorance. Of concern are incidents in which sensitive information was intentionally shared via social media.
Highlights
Do patients often suspect that health professionals (HPs) abuse their privileges of access by breaching the confidentiality of their data, patients are concerned about breaches arising from acts of indiscretion
This study has provided some insight into the reasons for the breaches committed by Picture Archiving and Communication System (PACS) users in the two hospital settings
It is impossible to design monitoring systems and guidelines to address the issues of confidentiality unless the breaches committed by PACS users are identified and classified
Summary
The breach of confidentiality involved access to paper and film records, which were often stored in a central location making it difficult to compromise the principles of confidentiality Despite this benefit, the paper system imposed disadvantages that became an impediment to the continuity of patient care because the records could be misplaced and difficult to retrieve resulting in delayed medical treatment (Beach & Oates, 2014). The paper system imposed disadvantages that became an impediment to the continuity of patient care because the records could be misplaced and difficult to retrieve resulting in delayed medical treatment (Beach & Oates, 2014) To address this limitation, advances in IT led to the development of a digital storage modality for radiology data (radiographs and reports) known as PACS. Of concern are incidents in which sensitive information was intentionally shared via social media
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