Confidentiality is the cornerstone of the patient-pharmacist relationship. Patients have a right to expect that their pharmacist(s) will hold their personal health information in strict confidence. In order to assist pharmacists in their obligation to preserve the privacy of their patients, the following guidelines were developed:

1. Personal health information is privileged and confidential and should not be released to any person without the consent of the patient or the patient’s agent (someone legally entrusted to handle the patient’s affairs). Confidentiality is owed to all patients, regardless of age. Therefore, pharmacists should use professional judgement in releasing information to the parent of a minor. In the case of older children, the consent of the child should be obtained prior to the release of personal health information.

2. Demographic information (address, date of birth, etc.) is also considered confidential. To ensure that this type of information is not inadvertently disclosed during the process of confirming patient identity, pharmacists should ask patients to provide information for confirmation purposes.

3. Pharmacists should not release any data which reveals any specific identifier or demographic information about patients or provide information about medication dispensed which could compromise the patient’s identity.

4. Pharmacists should take care that patient information is not seen or overheard by other customers, tradespeople, service crews, pharmaceutical representatives, etc., who may be in or about the dispensary.

5. Pharmacist/patient communication should take place in an area where discussion cannot be heard by others. An appropriate area should be established for consultation purposes, which includes at least one of the following:

· a private consulting room,

· a secluded area of the pharmacy, or

· a semi-private area with suitable traffic/noise barriers.

6. If a fax machine is used by a pharmacy to obtain any type of confidential patient information from outside sources, the fax machine should be physically located within the dispensary.

7. Pharmacists should develop a system to ensure patient confidentiality when delivering prescriptions. Only the information necessary for proper delivery should be visible on the package and all items should be packaged to prevent tampering.

8. Pharmacists should refer to the Society’s Policy on the Disposal of Prescription Information when disposing of prescription files, computer records and old vials.

9. A system should be developed to ensure that all dispensary staff respect the patient’s right to confidentiality. All dispensary personnel should be required to sign a confidentiality declaration.

10. Pharmacists should use caution when considering the release of personal health information to the patient’s agent. If unsure whether the person making the request is the patient’s agent, pharmacists should ask for written proof.

11. In the case of a deceased patient, the executor of the estate is entitled to ask for confidential information. A family member should have the legal authority to handle the deceased patient’s affairs before personal health information can be released.

12. Requests from family members (e.g. a spouse requesting duplicate receipts for income tax purposes) should be given cautious consideration. Personal health information should not be released unless the patient consents to the release.

13. If the best interest of the patient calls for the disclosure of personal health information to other pharmacists or attending physicians, and the pharmacist is unable to obtain the patient’s opinion on this disclosure, the pharmacist should use professional judgement in releasing this information. Steps should be taken to ensure that the person requesting the information is a legitimate pharmacist or physician.

14. Pharmacists should use caution when providing confidential information to third party payors. Generally, payors’ rights to personal health information is governed by the agreements they have with the patient and the pharmacy. Pharmacists should refer to these agreements when in doubt. Steps should be taken to ensure that the person requesting the information legitimately represents the third party and only the information necessary for claim submission should be disclosed.

15. Pharmacists are encouraged to cooperate with law enforcement agencies, however, confidential health information should not be released without a search warrant or court order. Pharmacists may testify in court and produce personal health records if they are ordered to do so by the courts. Only information referred to in the search warrant or court order should be disclosed.

Inspectors representing the Nova Scotia Pharmaceutical Society or the federal Department of Drug Surveillance may have access to personal health records by virtue of provincial and federal legislation.

16. Patients have the right to request and receive, from their pharmacy, a copy of their personal health information. Patients also have the right to expect that their health information will be maintained for at least two years.

Source: http://www.napra.ca/docs/0/203/245/594/680.asp