Having the option to make Case Notes private
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Youthrive Student 2
Having the option to protect confidential client notes from general viewing or perhaps to select who can view case notes (e.g. through "Case Manager", "Client Group", "Site" and "Case Status"). This will make it much easier to ensure client confidentiality and privacy for clients accessing a single service from a multidisciplinary team.
How to make it work / look: Possibly a check box in the 'Case Note' screen to 'make note private' (e.g. can only be seen by the specific practitioner, team, group, site) or a check box on the client home screen which identifies who is able to access and edit each file.
Thanks
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Matthew O'Carroll
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Jane Morgan
We would find it very helpful to have private case notes. We have had a dietician join our team who will have many joint eating disorder clients with our psychologists. Creating two separate files does not seem like an ideal solution. Many thanks
Steven Whittington
Hi Sonja,That's a challenging scenario in that in most cases the client is a client of the practice and usually, it's the practice's privacy policy that the client accepts and not the practitioners. Also, the coreplus account is generally held by the practice entity and not the individual practitioner (unless that are the one and the same).Password protecting a file within coreplus may feel like a good solution but it does then create other issues down the track, say for example the password is lost? What if the practitioner leaves, an unreconcilable dispute occurs with the practice or the practitioner unexpectantly dies how would the notes be accessed?Currently, clinical notes are restricted to the case manager of the client and those with supervisor access, and when the client is viewed the access is logged in the audit trail. Therefore I would suggest one or more of the following options:The practice has an internal policy of not viewing case notes unless there is a reason to do so i.e. the viewer is a case manager or supervising the case manager. A supervisor does spot checks on who is accessing what within the account in accordance with the internal policyOnly those that need to be a supervisor are granted the access levelIn addition to all of the above perhaps a new client record could be created within coreplus that either uses a pseudonym or code perhaps and the case note is stored in that record and not the main record of the client?Or, perhaps rather than adding a password to the case notes we could add a feature to set an alert to a nominated user that the case notes have been accessed by another user. This would support an internal policy and also prevent the issues relating to a password being lost or misplaced as it would only identify behaviour that was contrary to the expected business policy.What do you think?
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Kate Caldecott-Davis
Hi Steven Thanks for your reply to my query about securing case notes on CorePlus We currently have a situation where notes from a psychologist need to be kept completely private for legal reasons, however the client sees other clinicians who, at this point, are not authorised to view the very sensitive material that has been recorded As a team, our psychologists are very concerned about the ‘visibility’ that private session notes have on CorePlus and so we need a system that will fulfil our obligations to document our sessions while also protecting both client and clinician interests Would processes like password protected PDFs or something similar be possible through CorePlus to support the many multi-disciplinary practices that ae likely to come across these kinds of issues? Kind regards,Sonja
Steven Whittington
HI Sonja,It's great to see comments in the context of privacy of client data when shared with third parties. We've been working with government and industry for some time now on this issue and the current preferred solution is for client data requested by third parties to be shared via Secure Messaging. For example, NSW legal aid recently conducted a proof of concept whereby instead of asking to be faxed clinical reports they were sent via Secure Messaging which is encrypted and provides an audit trail of activity to ensure that the intended recipient not only received the report but accepted it. The good news here is that coreplus offers Secure Messaging and can do this today with over 73,000 connections on the network. The other option is a little more controversial today but seems to be where we are heading in the longer term. If the practitioner was to send the report/notes to the clients My Health Record and then they enabled access for the third parties to view it this would also satisfy the requirements. The ADHA seem to be favouring this approach whilst DHA seem to be working towards the ability to send a client correspondence to a personal secure message platform hosted in the my.gov portal.Until there is certainty regarding a preferred method being requested by allied practitioners and third parties it is unlikely that coreplus and other practice management software vendors will build all of these options as each is months of work and hundreds of thousands of dollars to build.
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Kate Caldecott-Davis
If a client divulges highly sensitive information that may be used later in a formal investigation by police, FACS or other protection authority, it is vital to have a mechanism by which clinical case notes can be compliantly recorded but protected. In light of the Privacy Act, this is a significant factor that practice management software needs to make provision for. Could the capacity for password protected PDFs or the like be added to Coreplus to support clinicians and clients who are in this situation?
Steven Whittington
Hi Joanna,Currently a Supervisor within an account can view case notes of all clients.Case manager have access to their clients case notes, and via Client Sharing/Feature permissions access to clients of other case managers.Admin have access to client records but not Case Notes unless granted via the Client Access permission within the client file. Given the current levels of access, I am not sure how recording client notes but not making them visible to other practitioners would further benefit clients? It may be worth having a chat with our support team in regards to the specific configuration of your account to review the current permission levels and to see whether adjusting those acheives the desired outcome.