At Veterans Affairs, Confidentiality is Meaningless

This story has been bouncing around the last day or so, but the more I think about it, the more disturbing I find it:

Confidential medical and financial information belonging to an outspoken critic of Veterans Affairs, including part of a psychiatrist’s report, found its way into the briefing notes of a cabinet minister.

Highly personal information about Sean Bruyea was contained in a 13-page briefing note prepared by bureaucrats in 2006 for then minister Greg Thompson, a copy of which was obtained by The Canadian Press.

The note, with two annexes of detailed information, laid out in detail Bruyea’s medical and psychological condition.

[snip]

The privacy documents show 614 people within Veterans Affairs accessed Bruyea’s computer file between 2001 and 2010, records that are kept in a password-protected computer database. Of those, 156 exchanged varying amounts of personal information, according to a trail of internal emails.

The material appears to have been shared with an additional 243 individuals, including both Liberal and Conservative political staffers, through briefing notes and emails during the 2006 transition between governments. [Toronto Star]

In health care, there is a term of art  — “circle of care” — which describes the health care professionals directly involved with a patient’s treatment, and by implication, those who have direct access to confidential information related to her or his care. For example, if you are hospitalized, your circle of care would include your primary nurse, your physician, and maybe some others — the physiotherapist, perhaps, or the social worker. Generally speaking, you can’t access the health records of any person outside the circle of care without explicit written consent of the patient. Papers need to be signed and so on.

I understand Veterans Affairs might need to request access to confidential medical records to assess benefits and treatment. What I’m having difficulty with is imagining circumstances where a cabinet minister, hundreds of bureaucrats, three senior civil servants, and staffers and various other flaks should have access to confidential medical information without permission. How is the Minister of Veterans Affairs part of the circle of care? Or, for that matter, a staffer in the PMO?

It’s disgraceful enough that the health care information of any Canadian, let alone a veteran, was used for political purposes. But the real scandal is the safeguarding within Veterans Affairs to protect confidential medical records of veterans. Apparently, there isn’t any.

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