While we live in a highly digitized world, we still rely A LOT on paper in healthcare. As we move towards even more integrated care, the reliance on and existence of paper health records will be a challenge to overcome.

From a privacy perspective, paper health records can be tricky to protect from loss, theft, unauthorized use and disclosure. The piece of paper offers challenges its electronic copy does not face.

Loss

Paper health records are vulnerable to loss in a way electronic records are not.  Floods and fires can decimate paper records without backup. If a paper record is misfiled, it may be lost forever, buried in another chart in a drawer with hundreds or thousands of other charts without the benefit of the Ctrl F  functionality leaving you with the only option of manual searching.

Shredding vs. Recycling

There are a number of privacy breach cases rooted in mistaken recycling of paper health records that were meant to be shredded. Confidential shredding bins are essential equipment for healthcare teams.  Still privacy breaches abound through human error. Leaving the key in the confidential shredding bin to make it easier to fit more paper leaves the bin vulnerable to interference.  Leaving overflow bags of shredding next to the confidential shredding bin can mean they are mistaken for recycling. Using “blue bins” as interim holding bins for what should be shredded can prove dangerous when cleaners mistake the blue shredding bin for a blue recycling bin.

Garbage

There is a JAMA study showing Canadian hospitals consistently found low to high sensitivity paper records with identifiable health information thrown into their garbage cans.

Inadvertent Viewing

Avert your eyes! Ever notice that bored patients or their family members will read ANYTHING available when they have to wait to be seen. They even read upside down!  When people are bored they will look for things to do.  Paper records of other patients make for fascinating reading.  Keeping a clean desk without paper records viewable to passersby can be challenging to maintain.

What’s a Privacy Officer to do?

Most healthcare teams deal with paper health records to some extent.  Privacy Officers should not forget that paper likely exists in your team and make sure to include tips on how to protect paper records in your privacy training and reminders.