Hospital employee fired after wrongly accessing patient records

An Ontario hospital worker’s firing for improperly accessing the patient records of her coworkers has been upheld by an arbitrator.

The worker was a clerical associate in the endoscopy and cystoscopy (endo-cysto) department of the William Osler Health Centre, a hospital in Toronto, who was hired in 1989. Her job duties included registering patients, compiling monthly statistics, and faxing and printing documents. She had access to a computerized information system called Meditech that was used to enter patient information at registration.

Meditech was password protected and employees were instructed not to share their passwords or leave their computers logged in as the systems contained private health information. In addition, Ontario legislation and the hospital’s policies only allowed persons in a patient’s circle of care to access a patient’s private health information. The hospital provided annual training on its policies and occasionally reviewed employees’ access to the systems.

In late 2018, the hospital generated a report revealing that on Sept. 11, 2018, the worker’s account accessed a patient inquiry record for another clerical associate who had been a patient in the cardiac care unit. In addition, the worker’s account accessed the records of a second clerical associate twice on Feb. 1, 2018, and a registered nurse’s breast screening clinic registration on Feb. 27.

The worker explained that she accessed the first colleague’s record on Sept. 11 because two nurses asked her to look up the coworker’s room number. Although hospital administration would have room numbers, she said that was how she always looked them up. She didn’t look at any other private health information when she did so, she added.

The worker also said that the Feb. 1 access of the second colleague’s file was related to the colleague’s registration for a consultation, but the colleague claimed she had been registered by someone else. As for the Feb. 27 access of the nurse’s breast screening registration, the worker denied doing so and couldn’t explain why the report showed that her credentials had been used.

The worker mentioned that on rare occasions — about once per year — she came back to her desk after lunch to find that her computer hadn’t logged out of the system. She assumed that the system hadn’t shut down properly. She also said that she had discovered nurses occasionally using her computer coming back from a break.

The hospital believed the worker intentionally violated patient privacy. Since she was a senior employee who should have been well-versed in hospital policies, it determined that the misconduct was serious enough to warrant termination.

The arbitrator found that it was unlikely that anyone else could have logged in with the worker’s credentials. The rare occasions when the computer didn’t log out properly didn’t match up with the frequency of the improper access and the union didn’t present any evidence to support the inference that someone else had the worker’s credentials, said the arbitrator.

As for the purposes of the accesses, the arbitrator noted that the worker may have legitimately needed to look up the coworker’s room number on Sept. 11, but it was not proper practice to use the Meditech system. The worker denied knowing any other way, but the annual training outlined what was permissible and the system showed a warning with every login about the need to protect patient privacy.

The arbitrator also found that the Feb. 1 access of the colleague’s information and the Feb. 27 access of the nurse’s breast screening registration were not “legitimate purposes for which she was entitled to access Meditech,” since she wasn’t in the circle of care.

The arbitrator determined that the misconduct was serious, intentional, and risked the hospital’s trust with patients. Since the worker failed to acknowledge any wrongdoing, the arbitrator agreed that termination was appropriate.