Repeated breaches of confidentiality lead to termination
Curiosity killed the career of a Saskatchewan-based physical therapist.
Joan McHattie, a physical therapist with 25 years of service and a clean discipline record, was fired after accessing the personal health information of 99 patients without authorization.
The persons affected were not McHattie’s patients, nor were they within her circle of care. Personal health information is confidential and restricted to health care providers on a need-to-know basis. The Prairie North Health Region found McHattie had no need for the medical information she accessed and dismissed her for the breach of confidentiality.
Two supervisors filed reports on McHattie’s breaches of confidentiality. In one incident, a supervisor became aware McHattie was accessing information on someone connected to the workplace. The second incident involved McHattie attempting to share with a supervisor the personal health information of a prominent member of the community who had recently died. The reports led to an audit of the employer’s Picture Archiving & Communication System (PACS), which revealed McHattie had accessed patient records multiple times, resulting in as many as 438 breaches of confidentiality over a period of several years. The names of patients whose information McHattie accessed included co-workers, supervisors, senior management, members of McHattie’s family and prominent members of the community.
McHattie maintained she did not know it was wrong to access the personal health information in PACS outside of her circle of care, as long as the information was not shared with others or used for improper purposes. She testified she accessed the confidential information out of "medical curiosity."
In May 2012 McHattie asked facility operations manager Laurie Gillespie for the name of a co-worker’s husband. He had recently suffered an injury and McHattie said she wanted to look him up on PACS. Gillespie wanted to report the incident but an employee she felt comfortable speaking with was on maternity leave, and Gillespie chose to wait for that employee’s return in October 2012 before filing a report.
In September 2012 McHattie brought up the recent death of a prominent community member with facility supervisor Carol Freeman. She testified McHattie then proceeded to type the man’s name into PACS to pull up his information. Freeman testified she told McHattie it was wrong to access the information.
On Dec. 6, 2012, McHattie was asked to attend a meeting concerning a privacy issue. Following the meeting McHattie was fired for "unethical and untrustworthy behavior," which the employer called inconsistent with her professional obligations as a health care provider.
The Health Sciences Association of Saskatchewan filed a grievance on McHattie’s behalf. The union argued termination was excessive when McHattie’s disciplinary record was previously unblemished. It requested she be reinstated and compensated for any lost wages and benefits.
The union also questioned the checks and balances put in place by the employer, arguing that had McHattie been properly trained in the issue of confidentiality and disciplined immediately after her breaches of confidentiality were discovered, she would not have continued to access the personal health information of patients outside her circle of care for such an extended period.
If necessary, the union submitted McHattie be reinstated without compensation until her return to work and that her reinstatement be subject to conditions restricting her access to electronically stored personal health information. The arbitration board, however, found these conditions did not do enough to mitigate the risk of relapse.
"The sheer magnitude of the confidentiality breaches perpetrated on such a diverse group of the public, at times on a daily basis over an extended period of time, is so appalling that we are not prepared to set aside the discharge," the board ruled. "This is not a case that lends itself to progressive discipline and the rehabilitation of the grievor."
The grievance was dismissed.
Reference: Saskatchewan Association of Health Organizations, Representing the Prairie North Health Region and the Health Sciences Association of Saskatchewan. William F.J. Hood, Al Shalansky and Michele Vogt — Arbitration board. Marilyn Penner for the employer and Peter J. Barnacle for the union. Feb. 5, 2014.
