某醫學中心員工對病歷隱私保護的認知與態度調查

A Survey on Staff's Cognition and Attitudes toward Medical Record Privacy Protection in a Medical Center

美國健康保險流通及責任法案（Health Insurance Portability and Accountability Act, HIP AA ）的立法精神現受認同，病歷隱私保護之執行已是全美醫療 主體必要的職責所在，國內某醫學中心自2004 年起，依美國病歷管理協會 （ American Health Information Management Association, AHIMA ）模式，首次在 醫院內推出病歷隱私保護宣導週活動一小密封運動。在辦理病歷隱私宣導週 前，對全院員工所進行的普查，回收3 ， 590 份（68.3% ）有效問卷。分析後發 現：員工高度認同病歷隱私之保護，有92.1% 受試員工認同保護病友隱私是醫 護及相關人員的倫理守則，惟78.5% 受試員工曾經聽過同仁在公共場所談論病 人病情，對於現行法規有關病歷隱私保護的理解有4 1. 7% 的受試員工不清楚， 而有一半以上（54.7% ）受試員工不清楚現行法規對於洩漏病歷隱私訂有罰 則。這些反映在83.3% 的受試員工認為，政府相關單位所提供的病歷隱私保護 訊息及宣導活動不足。對醫院推動病歷隱私宣導活動，有高達93.7% 的受試員 工表示會配合，而88.2% 認為這種宣導活動會加強對病歷隱私保護之認知。本 調查結果顯示，醫療相關人員對保護病歷隱私雖然有很高的專業倫理認知， 但醫療和衛生主管單位在宣導上仍然不夠，建議有必要加強對此方面之宣 導，以避免導致業務執行上的可能疏忽。此外，保護病歷隱私宣導活動的推 動可以獲得醫院員工高度的支持，據此，各相關單位及醫療院所宜重視「病 歷隱私保護」課題，及早檢視修訂相關制度與規範'並做有效推廣宣導，以 落實保護病人的病歷隱私。

The US Health Insurance Portability and Accountability Act (HIPAA) has been highly recognized. The core concept of the HIPAA is to protect the privacy of patients, and all of medical organizations in US are required to follow this regulation. A campaign of protection medical record privacy has been promoted in a medical center in Taiwan since 2004, comparable to that of the 'privacy week' held in US. Before this campaign, a survey was conducted to evaluate the status of this issue. Totally, we surveyed our medical staffs, There 3590 (68.3%) responded. Our results revealed that 92.1% respondents recognized privacy protection as the ethical obligation for medical staffs. However, 78.5% of them reported that their colleagues had talked about patients publicly. About 41.7% were unfamiliar with the initiation of medical records privacy protection and 54.7% didn't know unintentional disclosure of patient privacy is illegal. More than eighty percent agreed that instruction and campaign provided by the government were inadequate. Mostly (93.7%) would follow with the campaign and 88.2% agreed the campaign could improve the cognition of medical record privacy protection. In conclusion, although with high recognition of the importance of the protection patient' privacy, the implementation of medical record privacy protection is not satisfied and understanding of this issue is not good enough. Both the government and medical organization should enforce this issue by education and promoting the campaign.