It was while sitting in a doctors’ lounge and watching a janitor take away a huge recycling bin that Dr. Nancy Baxter stumbled on a major problem with the way hospitals operate.
Inside that bin, she saw paperwork containing the personal medical information of hospital patients. It was paperwork that should have been shredded, but instead, the janitor was planning to take it to recycling.
Dr. Baxter stepped in and made sure it got to shredding, but the incident left her wondering: how many other documents containing patients’ sensitive and personal information fails to get properly destroyed in hospitals?
She soon discovered it’s a disturbing amount.
Dr. Baxter, the chief of general surgery at St. Michael's Hospital, has just published a new research letter in JAMA that finds that while all patients have the right to expect their personal health information will be kept safe in hospital, that doesn’t always happen.
For her study, Dr. Baxter and a team of researchers rifled through the recycling bins at five Toronto hospitals to see what got left behind. It was an odd way to do research, Dr. Baxter admits, but the only way to get a real-life picture of the problem.
“We did dumpster diving in a scientifically rigorous way,” she told CTV News.
The team dressed as custodial staff and carted away the recycling bins around the hospitals, while also going through the giant bins of paper recycling in the waste collection area.
Altogether, they collected 591.6 kilograms of papers from emergency departments, intensive care units, hospital clinics and physician offices.
Among that half tonne of paper bound for recycling were 2,687 documents containing personal information that should have been shredded. Of those items, 802 were documents with low sensitivity, 843 with medium, and 1,042 with high sensitivity.
“We found everything from patient labels that would have your health care number and address and name, to things that were extremely highly sensitive,” Dr. Baxter said.
“We didn’t find many of those, but we found some things that, if they were about me, I certainly wouldn’t want them put into recycling.”
Though sensitive documents were found in recycling bins of all areas of all five hospitals, most of the items --1,449 of them -- came from physicians’ offices.
Dr. Baxter says her team’s finding shouldn’t cause patients to panic that their health information is not being kept confidential in hospital. Most personal paperwork that hospitals produce ends up being shredded properly. But she says it’s not surprising that some pieces of paperwork end up where they shouldn’t be.
“When you think about the amount of paper we generate with personal health information on it and the amount of recycling we generate, really, this is only a very small amount. So 999 times out of a 1,000 we get it right. But because there is so much sent to shredding, occasionally we don’t get it right,” she said.
Dr. Baxter has never heard of anyone having their personal information stolen or their privacy violated because of documents that weren’t properly destroyed. “But clearly, we don’t want this to happen, and we do have to do something to try to decrease this issue,” she said.
While the study looked only at five hospitals, Dr. Baxter says this issue is likely the same at others – or at any place that prints off the personal information of patients or clients.
“I don’t think this is isolated to any one hospital, or even just hospitals,” Dr. Baxter said. “I think any time you have personal information and you have the opportunity to put paper into recycling or into shredding, there’s always going to be human error.”
Ontario’s privacy commissioner Brian Beamish reviewed the study and says it is a good reminder that even though there is a move towards electronic medical records, there are still lots of paper medical records out there that need to be disposed of securely.
“And we’ve always said the way to do that is to shred them, not recycle them,” he told CTV News.
He says he supports the authors’ proposal that any place that keeps confidential records in paper form should have a shred-only policy.
“Don’t leave it up to staff discretion (to decide) if a particular record goes into the recycle bin or the shredding. Simply shred everything to avoid any unintended consequences,” he said.
With a report from CTV medical specialist Avis Favaro and producer Elizabeth St. Philip
