One of the most commonly recurring issues that features on the MPS advice line is confidentiality. In each edition of Casebook we will highlight an unusual scenario, at the heart of which lies a difficult dilemma around confidentiality
The use of ‘family files’ – where the notes of members of one family are kept together in one file – is quite common across general practice in South Africa.
The recent MPS caseload has demonstrated that there are significant risks attached to the use of family files, and as a result MPS advises against their continued use. Although there are no official guidelines against their use, the potential problems are fairly self-evident and include an increased risk of one family member having access to the records of another – therefore breaching confidentiality – and difficulty in providing records of only one family member when these are requested, for example by a solicitor when preparing a clinical negligence claim.
Family files can take on various appearances. Sometimes separate records are kept for each family member but they are all kept in one physical folder, often in the name of the primary member of the medical aid scheme concerned. Other times the clinical notes are entered chronologically on the same card or piece of paper, irrespective of which family member they relate to. Both approaches are examples of potentially risky record-keeping.
It is not good practice to have ‘family files’. Each family member should have their own file, which will assist in preventing accidental disclosures of one family member’s details to another family member.
It also means that when faced with a request for copies of any individual family member’s records (for example, if someone changes practitioners, or requires his/her records for medicolegal purposes), doctors may supply these without compromising the other family members’ confidentiality.