Public patients medical letters found in bin in Sydney in yet another privacy breach involving the health industry

April 21, 2017 |

Health privacy breaches are generally egregious.  The nature of the information is highly sensitive and extremely private. One would think that the breaches are rare to the point of extraordinary.  Yet they are not.  They are depressingly common.  And usually caused by poor document/data management.  Such as properly disposing of documents when appropriate.  Not so apparently given the dumping in a Sydney bin of 1000 medical letters involving the personal information of 700 public patients.  It is reported in Patient privacy breach: over 1,400 medical letters found dumped in Sydney bin.

The culprit appears to be a third party contractor engaged to transcripting medical letters sent from specialists to general practitioners.  That is an all too familiar story.  Contractors whose understanding of privacy and data security is at best spotty are often provided with sensitive information without any safeguards being put in place.

The Health Minister released a detailed media release,  Failure by private contractor to secure patient medical correspondence, which provides:

NSW Health is investigating the placement in a rubbish bin of copies of medical letters by a sub-contractor to a private medical transcription company, Global Transcription Services (GTS).

GTS has provided contracted transcription services to both private and public health facilities.

Outside transcription services have been a feature in some local health districts and private providers for more than a decade. Royal North Shore Hospital has engaged the company since 2010.

Timeline

On Tuesday 11th April a member of the public found a large number of follow up letters from specialists to general practitioners in a bin at an Ashfield apartment block.

The same day, police were advised and collected the letters and took them to Ashfield Police Station.

On Wednesday 12th April staff from Royal North Shore Hospital collected the correspondence from the Police, and after examining them referred them to the Ministry of Health on Thursday 13th April as the correspondence related to a number of private and public health facilities

The correspondence related to patients at Royal North Shore Outpatient Clinics, Gosford Hospital Outpatients and Cancer Centre, Dubbo Hospital Cancer Centre and six private providers:

  • Chris O’Brien Lifehouse providing services to Dubbo Cancer Clinic
  • Northern Cancer Institute, French’s Forest and St Leonards
  • Sharp Neurology
  • Southside Cancer Care Centre
  • Strathfield Retina Clinic
  • The Woolcock Institute

On Good Friday 14th April senior staff and clinicians in NSW Health undertook an initial review of the public hospital correspondence as the most important consideration was ensuring that patient care had not been compromised. No evidence of a need for immediate clinical intervention or for individual patients to be contacted was found.

The correspondence included letters from specialist doctors to referring general practitioners and treatment progress reports mostly relating to clinic attendances in December 2016. There were 768 public patients involved.

There were also just over 700 pieces of correspondence relating to private patients and these were forwarded to the relevant private providers.

Public patients

On Tuesday 18th April the letters involving public patients were referred to the relevant treating clinicians for review to ensure continuity of care for the patients concerned.

By Thursday 20th April letters were mailed to the clinical addressees to ensure the patients’ medical records are complete.

Private patients

Attempts were made to contact the six private providers on Good Friday. Three were contactable and on 14th April scanned letters were sent to Chris O’Brien Lifehouse and Sharp Neurology.

On the re-opening of private providers (Tuesday 18th April) all private providers were contacted and letters were sent the same day.

Transcription services

On Thursday 13th April, immediately on becoming aware of the incident, NSW Health informed Global Transcription Services (GTS) that it should cease printing and postal services for any NSW Health entity.

GTS was unaware of the incident until informed by staff at Royal North Shore Hospital. It advised over Easter that the breach occurred when a sub-contractor was responsible for processing the correspondence while the manager was on leave in January.

On Monday 17th April NSW Health was advised that the sub-contractor had experienced health issues.

As a direct result of the failure by GTS to secure and maintain documents properly, the NSW Minister for Health, Brad Hazzard, has directed that there should be an external review into the processes of transcription services in NSW public health facilities.  NSW Health has this week had preliminary discussions with consultants KPMG to conduct the review.

Privacy Commissioner

NSW Health has also written to the Acting NSW Privacy Commissioner to advise her of the incident.

Assistance for patients and clinicians

Each of the private providers will make their own arrangements for patients to contact them.

NSW Health’s primary concern has been to investigate and ensure that patient care is not compromised.

NSW Health asks that patients treated in the public facilities with any questions about their care contact one of the dedicated phone numbers:

  • Dubbo Cancer Centre – (02) 6809 6200
  • Gosford Hospital Outpatients and Cancer Centre – (02) 4320 3920
  • Northern Cancer Institute 0419 287 585
  • Royal North Shore Hospital Outpatients – (02) 9463 1409
  • South Side Cancer Centre 0419 287 585
  • Lifehouse – (02) 8514 1999
  • Sharp Neurology – (02) 8425 3546
  • Strathfield Retina Clinic – (02) 9746 3378
  • Woolcock Institute – (02) 9114 0000

?The article provides:

More than 700 public patients have had their privacy breached after more than 1000 medical letters were found dumped in Sydney bin.

NSW Health is investigating the incident involving a sub-contractor for a company tasked with transcribing medical letters sent from specialists to general practitioners, Global Transcription Services (GTS).

On Tuesday, April 11, a man found the piles of follow-up letters patient details stuffed into a garbage bin at an apartment block in Ashfield.

The man called over his neighbour, a female health worker, who recognised the documents were out-patient letters and contacted Ashfield police.

The sub-contractor who dumped the letters was woman going through a separation and had significant mental health problems, Mr Hazzard said on Thursday, adding it was inappropriate to comment further.

The incident has prompted Health Minister Brad Hazzard to launch an external review into the transcription services across all NSW public health facilities.

The letters related to 768 public hospital patients from Royal North Shore, Gosford Hospital outpatients and Cancer Centre and Dubbo Hospital Cancer Centre.

There were also 700 letters relating to patients from six private providers: Chris O’Brien Lifehouse, providing services to Dubbo Cancer Clinic, Northern Cancer Institute (Frenches Forest and St Leonards), Sharp Neurology, Southside Cancer Care Centre, Strathfield Retina Clinic and the Woolcock Institute. It is not known how many private patients were affected.

The bulk of the letters were treatment progress reports from specialist consultations in December.

The sub-contractor was supposed to take the letters home to post but instead stuffed them into the bin. 

Staff at Royal North Shore collected the letters on Wednesday, April 12 and contacted the health minister’s office.

Senior staff at NSW Health launched an initial review on Good Friday.

“No evidence of a need for immediate clinical intervention or for individual patients to be contacted was found,” NSW Health said in a statement. 

An external review of the processes of transcription services in state public health facilities will be conducted by KPMG, Mr Hazzard said. NSW Health has also alerted the Acting NSW Privacy Commissioner. 

Treating doctors were forwarded the letters on Tuesday to ensure continuity of care for the public patients involved on Tuesday. By Thursday the letters were mailed to the clinical addressees to ensure patients’ medical records were complete, the statement read. 

All the affected private institutions were contacted, and letters sent, by Tuesday.

This incident bolstered the case of an overhaul of the current paper-heavy health correspondence system and comprehensive switch to digital health record keeping, Mr Hazzard said.

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