Hospital patients are entitled to privacy even in hard times

The hospital examination room had space for four patients. Two of us were there. I was in one curtained section awaiting a scan, and in another sat an older woman whom I’d seen moments previously when, like me, she was called by full name from the line of chairs in the waiting room.

A consultant came in to see the woman. They had a candid discussion on her end-stage heart disease, which I overheard and could now match with her full name.

It was a disturbing event, even though the woman was a total stranger, and one I could not prevent short of covering my ears and singing ‘la la la’.

Such an occurrence would be a violation of federal privacy laws in the US, which state that patients not only have the right to have all such discussions in a private meeting room, but also that for others to be given personal health detail – other than the medical staff dealing directly with the patient – the patient would have to sign a consent form.

Sensitive

Even though medical information is correctly considered highly sensitive personal data and strongly protected in digital or written form under data protection law in the EU, such protection, bizarrely, does not extend to the possibilities of casual transmission inherent in typical Irish hospital examination and care rooms, in which multiple patients are grouped together with no privacy.

In the US, the Health Insurance Portability and Accountability Act details protection of medical information. Many states, such as California, have enacted laws that go further. Such privacy laws are driving changes that affect the business of healthcare and its costs. Adequate space must be provided to accommodate discussions between patients and healthcare staff.

In California as well as other states, new hospitals are also going for all-private rooms, or in some situations, a mix of mostly private with some semi-private beds, in which only one other person would share the room. Many hospitals promise to give the semi-private rooms to individuals as often as can be managed.

Stringency

Private rooms are not yet required under California law but many hospital administrators feel that’s likely to be on the cards, according to some past press reports.

That view was echoed by a visiting family member who was over in Ireland last week, who has worked in nursing and case management in California and Nevada. She noted the stringency staff needed to observe in handling and discussing patient information, whether in writing or verbally. She believes all-private room hospital would become the norm.

Private-room hospitals already accounted for just over 60 per cent of new facilities in the US by 2009, according to a research study by the Center for Health Design.

Patients of course far prefer private rooms – who wouldn’t? But there are health reasons too for a private room switchover. Studies have shown private wings have a lower spread of infections and that patients are less stressed.

In view of evidence that shared rooms prevent spread of disease and the risk of medical errors, as well as contribute to privacy violations, the American Institute for Architects has recommended single rooms in new-build hospitals, for post-surgery and childbirth.

Faster recovery times

With the average single hospital bed space costing more than $2 million (€1.5 million) in the US, once the high cost of technology is factored in, opting for single rooms rather than wards has a sobering impact on healthcare bills, whether paid for by individuals, insurance companies, or governments. But there are obvious cost benefits, if infection is reduced and less-stressed and better rested patients need beds for shorter periods due to faster recovery times. For most of us the major concern remains privacy.

In the present broken a Irish healthcare system, the prospect of mostly private room hospitals seems almost hopelessly aspirational. Surely the issue of the casual verbal transmission of medical information through the use of multiple person rooms must be addressed, to give such sensitive data the same protections obtained via data protection laws.

I do care about the health of my fellow patients. I just don’t want to have to overhear their personal details. And I shouldn’t be allowed to.