Data, facts and instruments on the German health system
What it’s all about
Data protection in medical practices is not only a fundamental requirement, but also an important building block for a stable relationship of trust between doctors and their patients. In reality, however, there are clear shortcomings, e.g. in terms of discretion.
TI and data protection
In the newsletter „Digital Health News“ of 10.08.2022, Elke von Rekowski and Folker Lück write on the topic of „TI and data protection“:
„Unquestionably, data protection is an immensely important asset worthy of protection, but as long as it is still considered perfectly normal in many doctors‘ practices to talk about illnesses, therapies or medicines for present patients in such a sufficiently loud way that half the waiting room can overhear it, the excited discussion about a minimal residual risk in TI security is first and foremost one thing: sick!“
In addition, many practices are not afraid to exchange sensitive patient data via email or messenger. In this respect, one can only agree with the two authors. However, data protection does not only concern digitalisation, but also the concrete work in medical practices.
The reality
One element of creating discretion is the separation of the registration and waiting areas. In every second doctor’s practice, however, precisely this regulation is not implemented or doctors and medical assistants do not make sure that the door between the areas is always closed and conversations cannot be overheard, despite the corresponding options. In addition, there are other indiscretions, for example:
- Staff members call out patient-related information loudly and audibly across the practice corridors.
- PC screens are visible,
- index cards are lying around openly
- Telephone calls can be overheard at the reception by waiting staff.
Patients react angrily
The feedback from patients in satisfaction surveys is clear: the Patient Care Quality Score (PCQS, the satisfaction of patients with practice performance features in relation to requirements, optimum: 100%) of discretion – viewed across all specialist groups – is just 19% .
Practice teams react with incomprehension
„There’s just no other way!“ is how most doctors and assistants comment on the lack of discretionary precautions in their practices. „I can’t close the door after every patient or check that no one is within earshot every time I make a phone call!“ a practice manager comments on the situation in her practice.
Patients argue differently
Until now, when patients complain about a lack of discretion, it was for a very private reason: they don’t want strangers to get information about their own circumstances and illnesses, because it is unpleasant, maybe even embarrassing.
For some time now, however, the argumentation has changed: Patients not only complain more often about the lack of discretion, but now also increasingly cite the argument of data protection. This moves the problem from an emotional to a factual level. This change is an expression of an effort to give more emphasis to the desire for discretion, because the data protection aspect is far higher in importance and scope than the emotional feeling, it applies without restriction and is untouchable.
Practice teams should become active
An obligation to maintain confidentiality with regard to patient information is, on the one hand, a legal requirement, because the obligation to maintain medical confidentiality is laid down in the legal system in several places. Moreover, the Federal Data Protection Act obliges practices to take both technical and organisational measures to ensure the protection of personal data. On the other hand, the protection of privacy as a performance feature of a „good medical practice“ increasingly influences the success of patient retention and acquisition, i.e. it is also a marketing instrument. With detailed analysis, a little goodwill and self-discipline, discretion can be significantly increased in most practices, even in smaller ones. Simple means are, for example, the establishment of a discretion zone at the reception or a sign with the request to always close the waiting room door, but also an ordering system that avoids queues.
Tracking down the unused opportunities
Discretion is only one component of practice performance. GPs and specialists who want to examine their work in a 360-degree view of strengths, weaknesses, threats and strengths can use the Practice Management Comparison© for this purpose. The validated benchmarking analysis can be carried out without the need for an on-site consultant and identifies an average of forty optimisation suggestions for daily work.